


■ ■ 



■ 



■ 



^H 



■HiH 
















*• f\(\ ~ 
























Fig. 39. 




Large Microscope. 



UROLOGICAL DICTIONARY: 



CONTAINING 

An Explanation of Numerous Technical Terms ; the 
Qualitative and Quantitative Methods Employed 
in Urinary Investigations; the Chemical 
Characters, and Microscopical Appear- 
ances of the Normal and Abnormal 
Elements of Urine, and their 
Clinical Indications : 



BY 



/ 



o 



/ 

JOHN KING. M. D 



With Twenty-seven Useful Tables and Thirty-nine Wood Cuts. 
. 1 



CINCINNATI: 
WILSTACH, BALDWIN & CO., 

Nos. 141 and 143 RACE STREET. 
1878. 



fr 






Entered according to Act of Congress, in the year 1878, by 

WILSTACH, BALDWIN & CO., 

In the Office of the Librarian of Congress, at Washington. 



PREFACE. 



The capability of examining urine to assist In the diagnosis, prognosis, 
and therapeutics of disease, as manifested by the numerous works that have 
already appeared upon the subject, is recognized at this day as an important 
and necessary acquisition to medical practice, — one which no physican who 
values his professional standing can afford to ignore or neglect. The present 
Dictionary, while it lays no claim to erudition, nor to originality, is designed 
as a multum in parvo to the physician and the chemist, affording information 
concerning urinary technicalities and urinary investigations together with 
their clinical importance, that is not to be found in any one book yet pub- 
lished, and which, it is hoped, will prove instructive and useful. 

In the determination or analyses of the several normal and abnormal 
elements encountered in the renal excretion, a number of tests and reactions 
are given that have been collected from the best sources, fully posting the 
reader, in these matters, up to the present time; and while many of them 
are tedious, frequently requiring a more thorough knowledge of chemistry 
than is generally had by the mass of practitioners, as well as a greater 
amount of time than can ordinarily be spared during an active practice, 
yet, in every instance where it was deemed necessary, the more simple and 
rapid processes have been described and pointed out by the indicator, t, as 
explained hereafter; so that examinations, sufficiently exact for clinical 
purposes, may be undertaken by any one without the embarrassing and irk- 
some complication of extensive chemical reagents, instrumental apparatus, 
repeated filtrations, drying precipitates, minute and exact weighings, etc., 
without loss of time, and without difficulty. To the medical man especially, 
these are important considerations. 

An exact knowledge of the quantity of any element, even to the fraction 
of a grain, that may be present in a given urine, as essential as it may be to 
science, is not so urgent for the medical practitioner, who can almost always 
satisfy all the requirements of practice, by simply determining the approx- 
imate amount of such or such important constituent, and then carefully 



iv PKEFACE. 

observing its daily variations, — whether it remains stationary, diminishes, or 
augments, under the influence of the treatment pursued. In the Preliminary 
Remarks much valuable information will be found, leading to the result 
just named. 

In the Appendix several Tables, etc., are given, to aid the investigator in 
effecting rapid calculations during his observations; and I embrace this 
opportunity to return my thanks to my young friends Mr. John U. Lloyd 
and Mr. Nathaniel W. Lord, for their kindness in furnishing the Table of 
Symbols. I must likewise acknowledge my indebtedness to the host of 
eminent authors from whose writings I have compiled much important and 
precious matter, in many instances, without special credit. Nor can I allow 
this occasion to pass, without expressing my gratification at the elegant style 
in which my publishers have issued the work. 

J. K. 

Cincinnati, February, 1878. 



PRELIMINARY REMARKS. 



N. B. For information concerning any urinary constituent, reagent, testing 
apparatus, or technicality, the name of which is italicised throughout the 
pages of this work, the reader will refer to it under its proper alphabetical 
heading. — It should likewise be stated that, with any given urine, the physi- 
cian can separately perform such investigation as he may judge proper, qual- 
itative or quantitative, without any preliminary operations (except for de- 
termining the presence of albumen), by simply turning to the article treating 
upon the urinary constituent in which he is interested, and pursuing the 
method (or one of the methods) therein named. A regular methodic analy- 
sis will require him to pursue the course indicated in the Table for Qualita- 
tive Analysis (page 10), and for Quantitative (page 11). For the advantage 
of practitioners who have not the time for lengthy and expensive processes, 
the more simple and rapid methods, with the ordinary normal and abnormal 
urinary elements, will, under their respective heads, be prefixed with the 
indicator J. 



Explanation of Abbreviations. 

c. c. Cubic centimetres. 

cgrms. Centigrammes. 

fl. oz. Fluid ounces. 

grm. or grms. Gramme, or grammes ; as Ogrm. .02,=two hundredths of 
of a gramme ; or 0.02 grm. 

mgrms. Milligrammes. 

min. Minims. 

mm. Millimetre : as 0mm. .006. = six thousandths of a millimetre ; or 
0.006 mm. 

sp. gr. Specifio gravity, 

X- Diameters: as X 500 = 500 diameters. 



The processes usually described for the examination of urine, as, repeated 
filtrations, drying and weighing of precipitates, volumetric operations, etc., 



6 PRELIMINARY REMARKS. 

together with the expensive and complicated instruments required, as, chem- 
ical balance, saccharometer, drying ovens, graduated burettes, etc., as desirable 
and valuable as they may be in the laboratory, or in the hospital, are embar- 
rassing and discouraging to the general practitioner, who, not having the 
time and many other material conditions, requires simple and rapid processes 
for his investigations. The important point for him is, to ascertain whether 
the urine contains elements not found in it when in a normal condition, and 
whether its normal elements are deficient or in excess ; bearing in mind that 
albumen, biliary coloring matter, and sugar, are the three most important 
morbid soluble substances met with in this fluid, indicating more or less dan- 
ger, the same as a deficiency of urea. It is not indispensable that he should 
know to the sixth part of a grain, the absolute quantity of such or such ele- 
ment present, but it is highly necessary that he should carefully watch its 
daily variations. And if, in testing the urine of a patient from time to time, 
he will always place himself under the same operative circumstances, and 
surround himself with the same precautions, he will be enabled to arrive at 
constant and sufficiently accurate results. 

In most instances, the physician has but little time to devote to quantitative 
analyses, and he will find the method, named hereafter in the succeeding par- 
agraphs, ordinarily sufficient to determine not only the presence of albumen, 
phosphates, urates, etc., in the specimens of urine under examination, but 
likewise their daily variations, — whether they increase or diminish in quan- 
tity, or remain stationary, — and thus be enabled to appreciate the value of 
the treatment pursued. True, this method is not an absolutely exact one, but 
it is sufficiently so for practical purposes, and what is lost in exactness is 
gained in the saving of time and in instrumental simplification. 

For the more extended urinary investigations the medical man should be 
fully provided with every convenience for prompt and accurate analyses. 
Among which may be named the possession of a small laboratory room fur- 
nished with shelves to securely hold chemicals and apparatus, so that they 
may always be within easy reach ; a stout, well-made table, four or five feet 
by two, and furnished with drawers for the reception of infrequently em- 
ployed materials; sufficient apparatus and chemicals, that there may be no 
delay nor trouble in the examinations ; a good light (a northern is prefer- 
able) for both the chemical and microscopical researches; various accurately 
computed tables for expediting the determination of certain reactions and 
results ; and in addition to which a blank book will be found decidedly use- 
ful for recording the various results of the investigations. The liquids and 
other chemicals should be pure, and, together with the apparatus, should be 
kept constantly clean when not in use, in their proper places, and easy of ac- 
cess for prompt and thorough examinations, so as to occasion the least possi- 
ble delay or inconvenience. Apparatus kept in an uncleanly or disorderly 
condition, impure or carelessly arranged chemicals, as well as an insuffi- 
ciency of apparatus and chemicals, are sources of great annoyance and 
inconvenience, interfere with precision and accuracy of results, and tend to 



PRELIMINARY REMARKS. 7 

render the practitioner disgusted with, and ultimately opposed to, all urinary 
examinations. 

In the examination of urine, the different specimens passed at various 
periods of the day, should be tested both singly and combined, especially in 
maladies presenting obstinate, severe, or obscure symptoms; and that re- 
cently voided should be examined at the time, and likewise after it has stood 
for 12 or 24 hours. And however difficult or troublesome it may be to accu- 
rately collect all the urine passed by a patient within 24 hours, it must be borne 
in mind that, unless this quantity be correctly known, the examination will 
be of no value, whatever may be the method of analysis pursued. It may 
be observed here, that, if the number of cubic centimetres of urine passed be 
multiplied by its sp. gr. the result will approximatively give the weight of the 
urine in grammes. 

For qualitative analysis, 200 or 300 c. c. (6 or 10 fl. oz.) of the urine are 
sufficient ; but when it is desired to follow the qualitative by the quantita- 
tive analysis, the urine to be investigated should be divided into two large 
parts, say 500 to 1,000 c. c. (16£ to 33| fl. oz.), each of which may be subdi- 
vided into as many portions as may be necessary. It will prove a great 
economy of time and money, beside giving much clearer results, to operate 
upon small quantities only, at a time, say 5 or 10 c. c. (81 or 162 min). 

The quantity of a precipitable substance in urine can be approximatively 
ascertained by placing a given volume of the urine in a graduated jar, or 
test tube, allowing it to stand a sufficient time, and then observing the height 
of the precipitate that occurs ; by employing the same volume of urine in 
this manner, daily, and observing the height of the precipitate in each 
specimen at the end of 24 hours, or at the visit of the next day, closely 
comparable results may be obtained. In this manner may be followed the 
daily quantitative variations of such or such element, and the curve they 
represent may be traced in a book kept for this purpose. Substances, which 
it is not desirable to test in this manner, may be removed from the urine, by 
agents that will rapidly precipitate them, — the precipitate being removed by 
filtration; or, they may be prevented from precipitation by the addition of 
an agent or agents that will hold them in solution. 

In disease, whether acute or chronic, it is frequently required that the 
urine passed for several consecutive days must be examined daily, or oftener, 
before the average condition of this fluid can be correctly arrived at. And, 
in doing this, the several portions of urine passed during each 24 hours 
should be collected in separate vessels, so that samples of each one can be 
examined previous to combining them. 

The specimen of urine to be examined should be voided into a well 
cleansed bottle, and a small portion of it be at once tested, to determine its 
sp. gr., its acidity or alkalinity, its color, odor, general appearance, and 
whether albumen or sugar be present. This done, the remainder, or a por- 
tion of it, should be placed in a clean cylindrical vessel, and covered, so aa 
to keep out dust and foreign matters. It is then to be set aside until a sedi- 



8 PRELIMINARY REMAKES. 

ment is formed at the bottom of the fluid ; in summer this requires about 
12 hours, and about 24 hours in winter. Small portions of this sedi- 
ment are to be removed, by means of a small pipette, for microscopical or 
clinical examination, as may be required. Ordinarily, the urine first 
passed early in the morning, or the last half of it, is that which is examined ; 
this will usually answer to give a general idea of the condition of this fluid, 
but where completeness and accuracy is required, samples of the whole of 
the urine passed in 24 hours must be analyzed, as heretofore observed. 
It must not be forgotten that, even in a state of health, the urine will 
be found to vary more or less daily, in its specific gravity, its acidity, its 
color, and the amount of its constituents. Too great a variation is the evi- 
dence of some morbid condition of the system. 

In most cases the principal characters of a urinary deposit may be deter- 
mined at the bedside, by means of a Coddington or Stanhope lens; or, still bet- 
™ -. ter, by a portable pocket microscope. But, if the deposit cau 

not be examined at once, and has likewise to be carried some 

T distance for this purpose, it will be useful to have several 
small well-closed sample tubes, in each of which a few drops 
of the deposit maybe placed; these should be wrapped in 
paper, upon which the patient's name is written. To prevent 
any change or putrefaction, a layer of oil will serve to protect 
the deposit from atmospheric contact, provided the tube be 
exactly filled before closing it. A small fragment of cam- 
CoddingtonLens. phor> or a jj^ carbolic water ( car bolic acid 1, water 1,000), 

will likewise answer. 

In all instances, when a specimen of urine, or of a urinary deposit, is 
presented for investigation, it is necessary to ascertain how long since the 
fluid was voided, in order to determine concerning any changes, decomposi- 
tion, etc., that may have occurred. And, in cases where several days may 
pass before a specimen of urine can be examined, it may be preserved by the 
above named articles, or by the addition of chloral, 10 grains to each fluid- 
ounce of urine; or, of salicylic acid, 3 grains to each fluidounce of urine. 
However, chloral is not suitable for urine that is alkaline, or that contains 
sugar, or urates, as it seriously interferes with the tests ordinarily employed 
for the estimation of these substances. Larjorrois states that l-40,000th its 
weight of fuchsine, or aniline violet, will thoroughly preserve urine from 
putrefaction. The addition of a little borax will likewise preserve urine for 
several days, but should not be used where the determination of soda salts is 
required. 

Albumen, it should be remembered, embarrasses or prevents both qualita- 
tive and quantitative analyses; hence, when present, it should be promptly 
removed by one of the processes hereafter indicated. It will also be 
proper to refer to the article on Sugar before proceeding to the other exam- 
inations. 



PRELIMINARY REMARKS. 9 

In order to effect a systematic examination of a specimen of urine, the 
following order will be found the most convenient, always ascertaining the 
quantity of this fluid passed each day, for several successive days: 

1. Observe the color and appearance of the urine. 

2. Observe its odor. 

3. Examine its reaction, whether acid, neutral, or alkaline. 

4. Ascertain its specific gravity. 

5. Test for albumen. If albuminous, examine under the microscope for 
Renal Casts, Pus Corpuscles, and Bed Blood Corpuscles. If the urine contains 
albumen, remove it, and then test the filtered urine for other substances, if 
indicated. But if neither albumen or sugar be present, unless there be some 
special indication, no farther examination will be required. 

6. Test for sugar. 

7. Test for coloring matters, normal or abnormal. 

8. Any sediment found in urine, which has been allowed to stand for 
12 or 24 hours, must be examined microscopically, and often chemically. 
The more common sediments are: 

A. Pink or reddish, and dissolved on heating it in the test tube, — urates. 

B. White crystalline, dissolved when acetic acid is added, — phosphates. In- 
soluble in acetic acid, but soluble when nitric acid is added,— oxalate of lime. 

c. White amorphous flocculent, becoming ropy when liquor potassa, or 
ammonia, is added, — pus. 

D. Brownish-red crystalline, — uric acid. 

E. Red amorphous, — blood. 

Other substances may be present in the urine, as spermaiozoids, fungi, epithe- 
lial cells, cancerous fragments, mucus, biliary pigments, or acids, leucin, tyrosin, cys- 
tin, carbonate of lime, hippuric acid, extraneous substances, etc. 

Or, the order given in the following table (on page 10), which slightly 
varies from the preceding, may be pursued, and will give similar results; 
for the details refer to the articles in the body of the book. 



10 



PRELIMINARY REMARKS. 



I. General Table of the Course to Pursue for Qualitative 

Analysis. 



i. Color 



of the urine. 



Normal 
colors. 



Abnormal 



colors. 



Urine pale ; colorless to straw yellow. 

do normal; golden yellow to amber. 

do highly colored ; reddish yellow to red. 

do dark colored; brownish; dark, beer color. 

~ . . . • f Coloring matters of the blood. 

Essential arising Bm | 

'VthVnZ^ 1 UroxZnthine; indican. 
of the organism. [ Uroerythrin . 

Accidental, de- f 
rived from with- 
out, and only pass- j Various coloring matters. 
ing through the 
organism. 



2. Odor. 



Essential. 



Normal, sui 
generis. 

Abnormal. 



Accidental, from 
odoriferous sub- 
stances introduced 
into the organism. 



Very va- 
ried by 



Urinous, due to Carbonate of Ammonia. 

Sulphureted? (Beale). 

Asparagus. 

Oil of Turpentine. 

Cubebs; Copaiba. 

Sandal, etc. 



3. Aspect. 



Urine clear. 

do turbid (slightly). — Cloudy or Flocculent. 
See Mucus, Epilhelia. 
Urine sedimentary. — See Examination of Sediments. 



4. Chemical f Normal. 
reaction with 
litmus. 



Abnormal. 



Acid. 

Neutral 



By Carbonate of Ammonia. 
Alkaline. \ By fixed Alkalies. 



5. Specific 
gravity. 



1015 to 1020. — Normal. 

A persistent sp. gr. below 1015. — Test for albumen. 
1028 to 1050. — Test for sugar ; excess of urea. 
1001 to 1008. — Test for deficient urates. 

1005 to 1030. — Test for phosphates. See sp. gr. of urine, with each urinary 
constituent. 



6. Detection of the abnor- 
mal elements in the urine. 
(Divide the urine into several 
portions, in which we succes- 
sively search for the following 
principles: 

7. Examination of the sedi- 

ments. 



Albumen. 
Sugar. 

Bile. 

Blood. 
Fibrin. 
Fat. 



f Coloring matters. 
\ Biliary acids. 



Microscopically and Chemically. 



In a methodical investigation of urine, quantitative analysis must perfect the 
information obtained from the qualitative. But as regards medical practice ex- 
clusively, it is rarely necessary to perform a complete and exact analysis ; however, the 
medical man may be frequently desirous of effecting the quantitative analy- 
sis of such or such urinary element, the variations of which he is interested 
in ascertaining. Therefore, the following brief table defining the order to be 
systematically pursued in this analysis, is given ; the detection and deter- 
mination of the urinary constituents will be found in the body of the work 
under their respective heads. — 



PRELIMINARY REMARKS. 



11 



i. Quantity 
of urine ex- 
creted in 24 
hours. 



II. General Quantitative Analysis. 

Averaging 1,500 grammes (about 60 fl. ounces.) 



Varia- 
tions. 



According to 
the following 
physiological 
condition: 



According to 
the pathologi- 
cal condition. 



a. The more 
or less copi- 
ousness of wa- 
ter in the 
blood. 

b. The ex- 
cretory activi- 
ty of the kid- 
neys. 

Diminution 
of urine. 



Increase of 
urine. 




Acute dis- 
eases. 

Approach 
of death. 

The in- 
crease tem- 
porary. 

The in- 
crease per- 
manent. 



2. Den 
of the 






Normal 



3. Quanti- 
ty of urinary 
pigment. 



4. Quantitative analysis of some of the 
constituent elements of the urine. 



Hydruria. 
Dropsy. 

Polyuria. 



Uroheinatin. 
Bile Pigment 
Blood. 
Accidental. 



Urea. 
Uric acid. 
Phosphates. 
Chloride Oj 

Sodium. 
Sulphates. 



Instruments and Reagents. 

These will vary according to the character of the analysis, and the extent 
to which the physician wishes to carry his investigations. He should always 
have a book in which to sketch, as far as possible, the various appearances 
met with in the urine in its original state, as well as when acted upon by re- 
agents; he should likewise possess another book in which is kept the date, 
name of the person, age, occupation, etc., appearance and character of the 
urine, symptoms present, curves of variation of important urinary charac- 
ters, when these can be examined daily, reference to drawings in the draw- 
ing-book, as well as to the treatment, and its result. 

H. Bedside Case. 

A neat pocket case, holding the articles named below, carefully and com- 
pactly fitted, and, at the same time, easy of access, will be found very useful 
for urinary investigation at the bedside : — 

Urinometer. 1 small vial Acetic Acid, £ fl. oz. 

3 test tubes, £ fl. oz. each. 1 " " Liquor of Potassa at T ^th 

1 small alcohol lamp. \ fl. oz. 

1 watch glass with wire support 3 glass slides and a few thin glass 

and handle". covers. 



12 



PRELIMINAEY REMAEKS. 



1 graduated small pipette, 6 in. long. 1 small brass forceps. 

1 small thermometer. 2 small vials for extra reagents when 

1 wire holder for test tubes. required. 

Strips of blue and red litmus paper. Small plate of platinum. 

1 glass jar of 2 fl. oz., graduated into half fl. drachms ; or of 8 grammes 

graduated into c. c. 
1 Coddington lens ; or a small microscope of about 200 diameters (Nachet). 

More extensive investigations in the medical laboratory will require cases 
containing the instruments and reagents as follows : 

The fluids named should be in quantity from 2 to 4 fluid ounces each, with 
the exception of alcohol and water, which should be in the quantity of from 
6 to 8 fluid ounces each. 



II. Instruments for Qualitative Analysis. 



6 or 12 test tubes. 

4 conical glasses, or champagne 
glasses. 



Fig. 2. 



Fig. 3. 





Conical Test Glasses. 



2 or 4 porcelain capsules. 

Alcohol lamp. 

2 small dropping pipettes. 

These should always be well cleansed immediately after use, so as to be in 
readiness for the next investigation. 



1 pipette, graduated into 5, 10, and 

20 c. c. 

Achromatic microscope of X 300 to 

X500. 
Slides and thin glass covers. 
Urinometer and containing glass. 
Small thermometer. 
1 burette. 
Filtering paper. 
Blue litmus paper. 
Eeddened litmus paper. 
1 graduated cylindrical jar of 1,000 

c.c. 
1 glass funnel. 

Swabs for cleaning test tubes. 
3 glass stirring rods. 
Coddington lens. Fig. 1. 
Small brass forceps. 



Reagents for Qualitative Analysis. 



Pure Nitric Acid. 

" Hydrochloric Acid. 

" Acetic Acid. 

11 Sulphuric Acid. 
Nitroso-nitric Acid. 
Chromic Acid, 4 grs. to 1 fl. oz. 
Alcohol. 
German Yeast. 



Distilled water. 

Solution of Acetate of Lead, 1 part 

to 4 parts of distilled water. 
Liquor Ammonia. 
Liquor Potassa. 

Pavy's Solution in separate parts. 
Tincture of Iodine, 1 part to 4 parts 

of distilled water, 



Besides the other reagents named throughout the work. 



PRELIMINARY REMARKS. 



13 



If pharmacists would keep pure chemicals on hand, they could dispense 
the reagents whenever the physician's prescription therefor was received. It 
seems to us that, in examinations made at the bedside, the patient should 
bear the small expense of investigations pursued in his interest; and, it is 
very frequently the case that, where daily examinations are desired, the 
physician can instruct some intelligent person around the patient how to 
conduct the processes, and observe and report the results. 

Figs. 5 and 6. 



Fig. 4. 





Wash Bottle. 



Graduated Glass Jars. 



III. Instruments for Quantitative Analysis. 



Urinometer and containing glass. 
Apparatus for determining urea. 
Nest of beakers. Fig. 8. 

2 precipitating jars. 

3 conical glasses. Figs. 2, 3. 
12 test tubes, and rack. 

4 porcelain capsules, various sizes. 
Small platinum capsule. 

Hot water drying oven. Fig. 9. 

3 glass stirring rods. 

Sp. gr. bottle, 50 or 100 grms. 

2 funnels ; large and small. 

Blue and reddened litmus paper. 

Wash bottle for washing precipitates 

on filter. Fig. 4. 
2 graduated burettes, and holder. 

Fig. 32. 



Copper water bath. 
Portable sand bath. 
Thermometer. 
12 glass slides. 
24 thin glass covers. 
2 brass forceps. 
Agate mortar. 

2 dropping pipettes. 

3 pipettes of 5, 10, and 20 c. c. 
Figs. 11 and 27. 

Pipette of 50 c. c, graduated into 

T Vths. Fig. 28. 
Small retort stand. 
Litre flask. Fig. 38. 
Chemical balance to weigh at least 

5 Vth grain. Fig. 7. 
Sett of gramme, and grain weights. 



14 



PRELIMINARY REMARKS. 



2 graduated glass jars of 100 c. c. 
and 500 c. c. Figs. 5 and 6. 

Fig 7. 




G5* 



2 test tube holders. 

6 ground glass covers. 

Graduated test glass. 

Microscope, of X 100, 200, and 500 
or thereabouts. 

Platinum foil. 

Platinum wire. 

Spirit lamp. 

Blowpipe. 

2 small tripods. 

6 watch glasses. 

Bibulous paper. 

Filtering paper. 

Cylindrical jar of 2,000 c. c. gradu- 
ated into |ths. 



Chemical Balance. 



Reagents for Quantitative Analysis. 



Absolute Alcohol. 

Alcohol, 95 per cent. 

Sulphuric Acid. 

Hydrochloric Acid. 

Nitric Acid. 

Oxalic Acid. 

Lime Water. 

Baryta Water. 

Chloroform. 

Ether. 

Pavy's Solution, in separate parts. 

Perchloride of Iron. 

Bichloride of Platinum. 



Distilled Water. 

Ammonia. 

Oxalate of Ammonia. 

Liquor Potassa. 

Solution of Soda. 

Solution of Hypochlorite of Soda* 

Carbonate of Soda. 

Phosphate of Soda. 

Chloride of Ammonium. 

Chloride of Calcium. 

Chloride of Barium. 

Nitrate of Silver. 

Sulphate of Copper. 



Volumetric Solutions, 
Besides the other instruments and reagents referred to throughout the work. 



Fig. 8. 




Beaker Glasses. 



The Beaker Glasses, Fig. 8, should consist of thin, well an- 
nealed glass ; they are used for containing hot fluids, as well 
as for heating fluids when an elevated temperature is re- 
quired. Precipitating jars are for collecting precipitate in 
quantity. Conical glasses, Figs. 2 and 3, are for containing 
urine to determine sp. gr., and to collect small amounts of 
precipitate from any given specimen; the bottom of the 
cavity of these glasses should be pointed, not rounded. Por- 
celain capsules are for heating substances that can not well be 
placed into the beakers; in observing reactions, they are 



PRELIMINARY REMARKS. 15 

seen best on a white ground; also for the evaporation of fluids. Platinum 
oapeula, foil and wire, are for holding matters requiring an elevated tempera- 
ture, for calcination, fusion, or decomposition, and for ascertaining the effects 
of intense heat upon minute fragments of calculi, sedimentary substances, 
etc. Bloicpipe,\o direct the flame of the spirit lamp upon bodies to be cal- 
cined or fused. Sand bath, a shallow sheet-iron vessel, filled with hot sand, 
upon which is placed a glass vessel, or porcelain capsule, watch glass, etc.; 
the iron vessel is exposed over a spirit lamp, or other source of heat, and 
the temperature raised to the degree required. Water bath (seen to the left 
of Fig. 10), is a copper or porcelain vessel containing water, and in which 
fluid another similar vessel, capsule, or glass dish, holding a fluid to be 
heated or evaporated, is placed, and the whole is then exposed to a source of 
heat, as required. Hot water drying oven, Fig. 9, is a copper vessel, in which 

substances are placed to be dried that t,. » 

, , . Jcig. y. 

require for this purpose a temperature 

higher than that of boiling water ; when 
a less elevated temperature is requir- 
ed for dessication, a tin water bath is 
employed. Tripods, Retort Stands (seen 
to the right of Fig. 10), are for hold- 
ing vessels under exposure to lamp 

heat, and for supporting filters, dishes, 

' rr & > > Hot -Water Drying Ovea. 

retorts, etc. 

Dilute solutions of the different reagents are made by the addition of 1 
part of the chemical agent to 1, 2, 4, 8, or more, parts of distilled water, as 
may be required. In all cases the reagents employed should be strictly pure, 
else there will constantly be a risk of having an investigation interfered 
with or rendered useless by some unforeseen and inexplicable accident. As 
quantitative or volumetric analyses are generally conducted in a labora- 
tory, the practitioner undertaking them may keep on hand a quantity of 
each reagent, say 1 or 2 ounces of solid chemicals, and 6 to 8 ounces of 
liquids, or even more, the bottles containing which should be closely stopped. 
The small bottles, with capillary orifices (Beale's), for holding the principal 
fluid reagents, will be found exceedingly useful in micro-chemical investi- 
gations. 

All the apparatus, reagents, and volumetric solutions may be had of 
Messrs. Bullock and Crenshaw, No. 528 Arch Street, Philadelphia, Pa.; of 
Mr. E. B. Benjamin, No. 10 Barclay Street, New York City ; of Mr. W. J. 
Rohrbeck, No. 4 Murray Street, New York City, etc. Dr. W. H. Pile, of 
Philadelphia, furnishes accurate urinometers, minim, and other graduated 
pipettes, specific gravity bottles, glass tubes, jars, etc., graduated as may be 
ordered. Practical chemists, most philosophical instrument makers, and 
first-class surgical instrument makers, can supply many of the articles re- 
ferred to. 




16 



PKELIMINAEY REMARKS. 



Fig. 10. 




Chest of Apparatus and Chemicals for Urinary Analysis. 



ABN 17 ACE 



UROLOGICAL DICTIONARY. 



A. 

Abnormal Constituents of Urine, when met with, indicate the existence 
of more or less serious disease, and afford the practitioner highly important 
information. Each one of these constituents is significant of a particular 
disease or morbid condition, that has occasioned its presence, the detection of 
which enlightens the diagnosis in cases of doubt and obscurity, especially in the 
earlier stages of such disease. The more common and important abnormal 
constituents are, in point of order : albumen, sugar, bile, blood, fibrin, fat, leucin, 
tyrosin, and some likeviise include urinary sediments, considered abnormal not 
in point of composition, but in point of place. Those less frequently encount- 
ered, and the indications of which are imperfectly understood, are : alkapton, 
inosite, benzoic acid, lactic acid, butyric acid, allantoin, and sulphureted hydrogen. 

Abnormal Deposit in Urine. Any visible deposit in urine which has 
stood from the time of voiding for twelve or twenty-four hours. See Urin- 
ary Sediments. 

Accidental Abnormal Constituents of tbe Urine, are those substances 
which are derived from food, drinks, drugs, etc., and which pass into the 
urine either changed or unchanged. Their presence is not always a patho- 
logical indication, though it is frequently useful to determine such presence, 
especially in cases of poisoning, when the toxic agent has passed into the 
urine. The processes to pursue for such determination, are the same as are 
employed when such substances are found mixed with organic matters, as 
in cases of death from poison. These accidental constituents are alkaline 
carbonates, antimony, arsenic, benzoic acid, bismuth, bromine, bromide of potassium, 
camphoric acid, chlorate of potassa, chloroform, cobalt, gold, iodine, iron, lead, mer- 
cury, nickel, phosphorus, quinine, salicin, santonin, senna, strychnia, succinic acid, 
sulphide of potassium, tannin, tar, zinc. See Coloring Matters; Urinary Sediments. 

Acetate of Lead. Lead or Plumbic Acetate. There are two acetates of lead 
employed in urin ary investigations : 1 . Neutral Acetate of Lead, Neutral Plumbic 
Acetate, Superacetate of Lead, Sugar of Lead, Lead Acetate, and which is de- 
termined from the subacetate of this metal by not causing a copious precip- 
itate with carbonic acid, which only partially decomposes it, and, likewise, by 
not forming a precipitate with solution of gum Arabic ; with sulphuric acid, 
acetate of lead forms a white precipitate of sulphate of lead, at the same 
time evolving vapors of a vinegar odor ; it also forms precipitates with lime 
water, sulphate of lime, the alkalies, and salt. In solution, it is used to pre- 
cipitate coloring matters of highly colored urine, when these interfere with the 
2 



ACE 18 AC1 

examination ; it does not precipitate the sugar in diabetic urine. It is also em- 
ployed as a reagent. The solution consists of 1 part sugar of lead to 4 or 6 parts 
of distilled water. Label : " Solution of Acetate of Lead for Decolorizing Urine." 
2. Basic Acetate of Lead, Basic Lead, or Plumbic Acetate, Subacetate of Lead, 
Diacetate of Lead, Tribasic Acetate of Lead. This salt, when added to gummy, 
mucilaginous, or saccharine solutions, causes a white flocculent precipitate, 
which is an intimate mixture of the organic substance and the oxide of lead. 
Tannin, albumen, and many animal substances are also precipitated by it. 
The organic substance may be eliminated by the addition of sulphuric acid 
to the precipitate, which forms an insoluble sulphate of lead with the 
oxide. Subacetate of lead also forms precipitates with the solutions of the 
alkalies or their carbonates, with sulphuric and hydrochloric acids free or 
combined, with the soluble iodides and chlorides, and with solutions of all 
the neutral salts. With carbonic acid, it forms a copious precipitate of car- 
bonate of lead. In solution, it forms a precipitate with most vegetable 
colors. When added to urine, it precipitates nearly all the coloring matter, 
as well as considerable saccharine matter should this be present, and hence 
should not be employed to render diabetic urine more transparent. Its solu- 
tion should be clear and colorless, and is made by dissolving 1 part of the 
basic sail in 4 parts of distilled water ; this solution has an alkaline reaction, 
is readily decomposed by the carbonic acid in the atmosphere, and, conse- 
quently, should be kept in well-stopped bottles, and labelled : " Solution of 
Basic Acetate of Lead." 

Acetic Acid. This acid is employed pure, and also diluted, 1 part of 
pure glacial acetic acid in 5 parts of water. Acetic acid dissolves the earthy 
and triple phosphates ; the urates with subsequent formation of uric acid 
crystals ; and carbonate of lime with effervescence. It dissolves part of the con- 
stituents of pus and blood corpuscles, causes these cells to swell to nearly twice 
their natural size, and renders them transparent, showing a thin, clear outline, 
and one or more internal nuclei. It dissolves the fibres of muscular tissue and 
leaves intact the dartoic fibres. It does not precipitate albumen, but precipi- 
itates cystin from its ammoniacal solution. The dilute acid coagulates mu- 
cus, forming an opaque corrugated membrane, precipitates mucin in the form 
of fine threads, and renders the nuclei of the mucus corpuscles more distinct. 

Acetone. A colorless thin liquid, of sp. gr. 0.814 at 32° F-, and boiling at 
132° 8 / F. It is soluble in water, alcohol, and ether. Acetone is found in the 
urine and blood of diabetic patients, and imparts to the former its peculiar odor. 

Acidity of Urine. From 1.29 to 1.95 grammes pass in health during 
each 24 hours. This acidity is due to a cause or causes yet imperfectly 
understood. It may be owing to the presence of an acid phosphate of 
soda, or, to free lactic or hippuric acids, to acid urates, or, to some organic 
acid or its acid salt. Bence Jones supposed that the acidity of the urine 
may, to a certain extent, be taken as a measure of the gastric acidity. Vogel 
ascertained that the maximum of acidity in the urine was during the night; 
the minimum during the forenoon ; and the medium in the afternoon subse- 



ADI 19 AGE 

quent to the dinner meal. The urine is generally acid when just voided, 
as maybe determined by its reddening blue litmus paper; in health this 
acidity remains for several days, becoming more intense for a time, but 
should the acidity be lost within 24 hours after the voiding of the urine, it 
indicates some disease requiring prompt attention. The amount of the acid- 
ity should be determined as soon as possible after the urine has been voided, 
as it becomes more intense upon standing, except in a few instances, or when 
decomposition occurs. This is done by a volumetric process, carefully neu- 
tralizing the acidity by a solution of caustic soda, every c. c. of which indi- 
cates exactly 10 milligrammes of a solution of one gramme of pure, dry 
oxalic acid in exactly 100 c. c. of distilled water. 10 c. c of this solution of 
oxalic acid are placed in a small beaker, to which 6 or 8 drops of tincture 
of litmus are added, or enough to produce a distinct red color. Let this rest 
upon some white paper, and carefully add the soda solution until the orig- 
inal blue color of the fluid has been restored. Suppose this reaction has 
required 6 c. c. of the soda solution indicating 100 milligrammes of oxalic 
acid; we add to 600 c. c. of the soda solution 400 c. c. of distilled water, and 
thus obtain 1,000 c. c. of a standard solution, 1 c. c. of which neutralizes 10 
milligrammes of oxalic acid, and which should be tested to ascertain its cor- 
rectness. Now to 50 or 100 c. c. of the acid urine, gradually add this stand- 
ard solution, testing each time with litmus paper, until it no longer develops 
any redness, when from the amount of standard solution employed we can 
determine the amount of the unknown free acid of the urine equivalent to 
so much oxalic acid. In this process, it will be better to place a drop of the 
urine upon the litmus paper, from time to time, as the standard solution is 
added, and, also, to be careful not have an excess of alkali in the urine. — To 
lessen alkalinity of the blood and increase the acidity of the urine, diminish 
vegetable food and augment the animal; or use the stronger mineral acids, in 
proper doses, diluted, avoiding the vegetable. — The so-called "Acid Fermenta- 
tion " of acid urine, resulting in a decomposition of this fluid into ammonia, 
uric acid, fungus spores, etc., is supposed to be due to the presence of mucus 
and other organic substances, which, acting as a ferment, develop lactic and 
acetic acids during the progress of decomposition of these substances, and 
thus increase, temporarily, the intensity of the acidity of the urine. This, 
however, has not been satisfactorily demonstrated. See Chemical Reaction. 
Sulphydric acid (sulphureted hydrogen) in urine turns paper, washed with 
solution of acetate of lead, black. 

Atliposnria. Urine containing considerable fatty matter. 

Ag-ents that exert an influence upon certain conditions of the urine, are briefly 
as folloAVs:— 1. The solids are increased by digitalis, belladonna, colchicum 
carbonate of potassa, white Rhine wine, etc. — 2. The solids are diminished by 
citrate of quinia and iron, ammonio-citrate of iron with quassia, alcohol, 
beer, coca, tea, coffee, and Paraguay tea; also, by opium, morphia, conium, 
calabar bean, hyoscyamus, cannabis, etc., which, however, from their action 
upon the nervous system, may sometimes be contraindicated. — 3. The fluids 



ALB 



20 



ALB 



are increased by sweet spirits of nitre, beer, gin, turpentine, whisky, coffee 
without sugar or milk, large draughts of soft water, infusion of verbesina 
virginica, of triglochin maritimum, etc. — 4. The fluids are diminished by 
conia, citrate of quinia and iron; iron, copper, and ammonio- citrate of iron 
with quassia; arsenic and cantharides may almost wholly arrest it. — 5. Urea 
is increased by water, salt, coffee without sugar and milk, cubebs, cantharides, 
atropia, tea, bicarbonate of potassa, liquor potassa, eggs, gelatin, milk, ani- 
mal soups, jellies, and all nitrogenized foods. — 6. Urea is diminished by 
chlorate of potassa, sugar, starch, fat, cream, cod-liver oil, beer, coca, coffee, 
tea, Paraguay tea, all non-nitrogenized foods, citrate of quinia and iron, cal- 
abar bean, benzoic acid, acetate and phosphate of soda, colchicum, acetate of 
potassa, quinia, alcoholic drinks. — 7. Uric acid is increased by phosphate of 
soda, bicarbonate of potassa, liquor potassa, alcoholic drinks, beer, port wine, 
catawba wine. — 8. Uric acid is diminished by tea, coffee, quinia, colchicum, 
atropia, acetate of potassa, cod-liver oil, alcohol, matico and epigea repens. — 
9. Alkalinity is increased by alkalis, alkaline carbonates, alkaline mineral wa- 
ters, apples, lemon or orange juice, citrates, tartrates, and acetates ; cod-liver 
oil lessens acidity. — 10. Alkalinity is diminished by acid phosphates, chloral 
hydrate, benzoic acid, Campeachy wood, salicylic acid, alcoholic drinks, etc. 

Albumen. In all cases the first and most important step, after observing 
the color, appearance, odor, and acid or alkaline reaction of the urine, is to 
determine the presence or absence of albumen, before proceeding to test for 
any other substance, and this should be done as soon after the urine has been 
voided as possible. It is not the occasional appearance of albumen in the 
urine that renders the prognosis unfavorable, but only when it remains per- 
sistently, and especially when it is attended with renal casts, r/us, or blood glob- 
ules. A low specific gravity of the urine would lead to a suspicion of albu- 
men, yet this substance often exists in the fluid when its sp. gr. is high. The 
following table will give the best course to pursue for the QUALITATIVE 
ANALYSIS : 



III. Table. 
$ Preliminary Steps. 



f a. The urine is turbid or sedimentary. 
\ b. The urine is clear and transparent. 

a. The sediment 
must be examined 
under the micro- 
scope. 



See 2. 
See 2b. 



Filter 

or 
Decant. 



b. The 
urine is 



filtered 



x. Acid 
Neutral. 



b y. Alkaline. 



See Detection. 

Neutralize with 
nitric acid until a 
slightly acid reac- 
tion is given, then 
see Detection. 



ALB 



2] 



ALB 



Remarks. — The neutralization advised above (2 y) may appear useless, be- 
cause in " Detection," below, it has been stated that the addition of l-10th 
nitric acid will neutralize the urine. But it may happen then that no pre- 
cipitate of the albumen takes place, even on heating, because the proportion 
of acid, a part of which will have been neutralized, will be found insuffi- 
cient; for it must not be forgotten that the addition of a few drops of nitric 
acid prevents the albumen from coagulating by heat, a fact due to the set- 
ting free the phosphoric acid of the urinary phosphates, in which albumen 
is freely soluble. But, if an excess of nitric acid be added, it displaces or 
predominates over the phosphoric acid, and the albumen is precipitated; 
hence, before proceeding to the Detection, the urine must always be brought 
to unity, that is, to a neutral or slightly acid reaction. It may be proper to 
observe, however, that when the quantity of albumen in the urine is quite 
email, nitric acid is apt to retain it in solution, for which reason many pre- 
fer acidulating the urine with acetic instead of nitric acid. The proportion 
recommended for acidulating the urine is 2 drops of acetic, or 0.5 c. c. of 
nitric acid, to 15 c. c. of urine. When the deposit (precipitated or not by 
heat) in the urine, consists only of phosphates, the addition of acetic or 
nitric acids renders the fluid clear by dissolving the phosphatic salts. 



1. Into a test 
tube containing 
10 c. c. of urine, 
pour 1 c. c. of 
nitric acid. 



IV. Table. 

t Detection. 

a. An evident coagu- 
lation is produced 

b. There is doubt; the 
liquid is only turbid, or 
there is a slight precipi- 
tate 



2. Heat 
liquor. 



the 



2z. The tur 
Lidity remains 



"{ 



c. The whole is redis- 
solved , 

d. The turbidity or 
the precipitate remains... 



Albumen. 



_ See 2. 

f Uric acid, 
Nitrate oj 
Urea. 

Albumen, 
or see 2x 



Add Alcohol in small 
quantity. 



{e. The turbidi- f 
ty disappears.. -I 
/. It persists.... ( 



Resins. 
Albumen. 



The step 2x, above, is necessary, when there is a certainty or suspicion 
that the patient has been taking cubebs, copaiba, turpentine, sandal, etc. 

Observations. — The preceding process is the clearest and most exact of any. 
It is useless for the physician to attempt processes for recognizing minute 
traces of albumen in the urine, as it would only embarrass him, and be of 
no advantage, from the fact that small quantities of albumen may be pres- 
ent in this fluid, under the influence of diet. It may be observed, relative 
to the above table, (referring to its letters and figures) that: — 1. The em- 
ployment of nitric acid is always disagreeable ; but, in testing for albumen, 



ALB 22 ALB 

it is preferable to acetic acid, which has the inconvenience of precipitating 
mucin. Again, it would be improper to conclude that, because cold nitric 
acid gives a white precipitate, an acid urine is albuminous, it is important 
that this precipitate be insoluble by heat. One-tenth of nitric acid is the 
most advantageous ; but, in doubtful or difficult cases t the testing must be 
repeated by adding more, as well as less, acid, and it should invariably be 
added drop by drop. — b. Any doubts may be removed by examining a drop 
of the precipitate under a magnifying power of 300 diameters ; either some 
amorphous, granulated masses of albumen will be recognized, or the crystal- 
line forms of uric acid, etc. It is usually prudent to wait a few minutes to 
afford time for these crystalline productions.— 2, c. If the fluid be again al- 
lowed to cool, the precipitate will be reproduced, as these salts are almost 
insoluble in the cold liquid. — 2 x, e. This cause of error (precipitate of 
resinous substances in the urine) has not been confirmed by any author since 
Maly made it known. It should be stated that when the urine contains 
much coloring matter, the albuminous deposit, instead of being white, is 
colored, greenish if biliary matters, brownish red if blood, and violet if indi- 
can, be present, etc. 

Other Methods. — The above method of qualitatively determining the 
presence of albumen will be found fully sufficient for all practical purposes; 
other methods, however, have been described, and it may prove useful to 
make a few of them known. — 1. Fill a test tube one-third or one-half of its 
depth with the suspected urine, and then allow 20 or 30 drops of pure color- 
less nitric acid to slowly run along the side of the inclined tube down to the 
bottom of the urine ; if albumen be present, it will appear in the form of a 
white disc, with a more or less distinct outline above the layer of acid, vary- 
ing in thickness according to the proportion of albumen. At times this disc 
is so transparent, that it has to be held in a certain manner in the light to 
become apparent; and, again, a few minutes may elapse before it will be 
seen. If the urine holds a large proportion of urates, uric acid will eventu- 
ally be separated, and, as a rule, will collect near the free surface of the 
fluid, being separated from the albuminous disc by a larger or smaller clear 
interval, and will show the crystalline forms of this acid under the micro- 
scope. Should it unfortunately happen that these crystals become mixed 
with the albumen, the experiment will have to be repeated. This is a deli- 
cate test, detecting 1 grain of albumen in 1,000 of urine, and is especially 
useful when the albumen is so small in amount as not to become recogniza- 
ble by heat. Should carbonic acid or carbonates be present in the urine, to 
such an amount as to occasion effervescence, this test will prove unavailable. 
Heller. — 2. Dissolve 10 grammes of tannin in 200 grammes of distilled 
water, and then add 10 grammes of ether to preserve the solution. This 
precipitates gelatin, modified albumen, and other organic substances from 
urine, and should be used for a long time consecutively, as, soups rich in 
gelatin, etc., cause the urine of persons eating them to give an abundant 
precipitate with this solution. Bouchardat. Two parts of tannin in 100 of 



ALB 23 ALB 

alcohol, when added to urine in the proportion of £th its volume, will de- 
tort } grain in 1,000 grains of urine; should urates be precipitated, heat 
will cause them to be dissolved. Almen. — 3. Place a portion of the sus- 
pected urine in a test tube, and carefully pour on it an equal quantity of 
ordinary alcohol, without allowing the two fluids to mix. At the junction 
of the two, a milky haze will be seen, and if the albumen be in considerable 
quantity, small prolongations of it will form in the alcohol. This will fre- 
quently show albumen where it is not suspected. Betz. — 4. Wash the albu- 
men, precipitated by heat or nitric acid, with water, to remove all traces of 
urine which interferes with the reaction ; then add a little liquor potassa to 
dissolve the albumen, and let a drop or two of the liquor of Barreswill (or 
of Fehling's solution) fall into the solution. Immediately a very fine, rich 
violet color demonstrates the presence of the albumen. If the albumen is in 
minute quantity, the solution must be heated. This color will be produced 
if T fa part of albumen be present. Boulaud. — 5. Place a few c. c. of a 
saturated aqueous deep yellow solution of picric acid into a test tube, at the 
surrounding temperature. Let a few drops of the suspected urine fall upon 
this, and if albumen be present, in passing through the solution, a charac- 
teristic whitish furrow or line will be produced. Although a good test, and 
one that may be applied in the presence of phosphates or urates, it is only 
useful when albumen is present to an amount greater than is required for 
most of the other tests ; on heating the fluid, the albumen collects in a lump 
and floats. Galippe. — 6. Albumen in the urine, or in solution, under the ac- 
tion of a polarizing apparatus (alburainimetre) turns the plane of polarization 
towards the left. Each minute of the instrument corresponds to 0.180 
grammes of albumen, each degree to 10.800 grammes. Becquerel. — 7. This 
process is sometimes employed to confirm the result of action of heat and 
nitric acid ; to a fresh portion of the urine add acetic acid, filter to remove 
mucus, and then add solution of potassium ferrocyanide. A white precipi- 
tate indicates albumen. — 8. Albumen is very soluble in phosphoric acid; 
hence, in examining urine for it, first, precipitate the phosphoric acid by add- 
ing a few drops of solution of chloride of lime, and then a little ammonia; 
let it stand for 24 hours, filter to remove the phosphates, and then test the 
filtered fluid for albumen. — J 9. To 100 grammes of urine add 4 or 5 drops 
of acetic acid, 2 c. c. of non-concentrated nitric acid, and 10 c. c. of a solu- 
tion composed of 1 part, each, of crystallized phenic acid and acetic acid, 
and 2 parts of alcohol at 90°. — Shake the mixture, throw it upon a filter, 
that has been carefully dried and weighed previously, and wash the contents 
of the filter with water holding 1 part of phenic acid to 100 of water in 
solution. Dry the filter, and weigh it. The difference between the two 
weighings of the filter will be the weight of the albumen present. Mehu. 

QUANTITATIVE ANALYSIS (or Estimation) of Albumen in the Urine. 
The amount of albumen passing with the urine may vary from a mere 
cloudiness to an ounce during the 24 hours, though this maximum quantity 
A3 uncommon; the average amount usually met with varies between 1J and 



ALB 



24 



ALB 



Fig 11. 



3 drachms in the 24 hours. The methods usually employed for the exact 
estimation of albumen in any given urine, are difficult to perform, and re- 
quire the use of accurate balances and weights. For ordinary clinical pur- 
poses an approximative process only will be necessary, one based upon the 
comparative estimation of the amount of albumen precipitated in a given 
volume of urine. — When the presence of albumen has been recognized by 
the process above indicated (in the table under Detection), it will suffice to 
repeat the operation in a graduated tube, agitating it strongly, and then 
allowing it to rest for twenty-four hours. (Tubes holding from 20 to 50 c. a, 
and perfectly graduated in fifths of a c. c, can be had for a dollar or two. 
Fig. 11.) The flocculent precipitate at first rises to the surface of the fluid, 
and afterwards falls to the bottom. When there is but little 
albumen, the precipitate may be hastened by gently heating 
the urine. This experiment must be repeated every day 
with fresh quantities of the urine, voided day after day, and 
by reading the height of the precipitate in the graduated 
tube on each occasion, a curve of the variations of the albu- 
men may be traced and preserved. 

This is a most excellent approximative method, giving 
correct comparative results, and may be employed for the 
estimation of several other precipitates. Thus, in diluting 
a fluid containing a precipitate of known height, with water 
one-half, this height will diminish one-half; whatever may 
be the diameter of the tube employed, the precipitate will 
occupy the same volume, although the heights will be natur- 
ally greater as the diameter of the tube is smaller. — If, in 
the performance of the above named process, the urine be 
filtered, so as to remove from it any epithelia, urates, or 
foreign substances, the result will be still more exact. 
When the amount of albumen is quite small, so that its 
depth in the tube is hardly appreciable, its proportion may be expressed by 
the terms, "cloudiness," or "opalescence;" in larger amounts by the terms, 
one-fourth, one-six, or one-tenth, etc., according to the height of the pre- 
cipitate. 

Other Methods. — 1. A very exact method, rarely required however, is to 
add acetic acid to a measured amount of urine, and boil it in a test tube. 
Collect the precipitate on a previously dried and weighed filter, wash well, 
dry, weigh in an accurate balance, and then calculate the proportion of 
albumen. — 2. Fill a wide-mouthed burette to a multiple of 100 with albumin- 
ous urine; add a slight amount of a solution of 4 grains chromic acid in 
1 fluidounce of distilled water; shake the mixture and set it aside for 24 
hours; read off the amount of precipitate, and calculate the amount of albu- 
men for the whole of the urine passed, by multiplying. J. DougaU. — 3. To 
the albuminous urine add one-half its volume of a solution of common salt, 
(2 parts to 10 of water), and shake the mixture. Now add solution of tan- 



V 

Pipette gradu- 
ated into 5ths. 



ALB 25 ALB 

nic acid until the albumen is completely precipitated. Collect the precipi- 
tate upon a weighed filter, and wash it with distilled water until all the salt 
is removed; after which, treat it with boiling alcohol until the filtrate passes 
without giving indications of tannic acid. Dry the filter and the precipitate; 
weigh it, and the weight, minus that of the filter, will give the amount of 
albumen present in the urine operated upon. This is stated to be a superior 
method. L. Girgensohn. 

Microscopic Examination of the Sediment of an Albuminous Urine. This sedi- 
ment may contain : 1. Crystallized salts, as uric acid, ammonio-magnesian 
phosphates, and oxalate of lime. Uric acid will be frequently met with in very 
pale, feebly acid urine of patients having albumin aria of long standing. 
Though Beale has stated that the presence of uric acid in albuminous urine 
would lead to the supposition that the case was acute and of short duration. 
— 2. Amorphous salts, as urates, phosphate of lime, carbonate of lime. — 3. Figu- 
urate, or amorphous elements of various characters, as, a. epithelial cells from 
the urethra, the vagina, the bladder, or the ureter, etc.; 6. leucocytes, blood globules; 
c. elements coming from the uriniferous tubules (renal casts), and which 
appear in the form of cylinders of varied aspect. — All these sedimentary ele- 
ments are referred to under their proper heads, which see. 

Albumen, precipitated from urine, when examined under the microscope 
with a power of 300 or 400 diameters, is in the form of small, irregular, 
granular, amorphous masses, not changed by acetic acid. For purposes of 
examination, it may be prepared by adding a small quantity of white of egg 
to some clear, fresh urine, shaking the mixture thoroughly ; precipitate the 
albumen by the method above named. Sometimes filamentous threads, 
debris of the lax cellular tissue enclosed in the albumen of the egg, will be 
present, and which may be removed from the urine by filtering previous to 
precipitating the urine. An aqueous solution of albumen treated with sul- 
phocyanate of iron gives a blood-red color, which is removed when a few 
drops of ammonia are added. — E. Keichardt states that he has found albu- 
minous urine to contain a substance very similar to dextrine. 

Clinical Import. Urine of sp. gr. 1010 to 1012. An albuminous urine may 
be considered an important objective sign of disease. It is met with in renal 
congestion, in many acute febrile and inflammatory diseases, in emphysema, 
heart disease, cirrhosis, poisoning by lead, abdominal tumors, etc., in which 
affections its presence may be owing to impediments of the circulation of the 
blood, to a specific poison, etc. Sometimes the urine may be albuminous for 
several consecutive days, and then disappear, without any attributable cause. 
It may also be present when an albuminous diet is continued for some time, 
as, for instance, the eating of eggs. Albumen is of more serious import 
when its presence is permanent, and the urine contains pus, blood, or casts. 
Pus and blood indicate disease or abscesses of one or more of the urinary or- 
gans. Blood may also be present in the urine in purpura, scurvy, and other 
debilitating maladies. Renal casts should always be carefully sought for when 
albumen is detected in the urine ; their presence, being dependent on struc- 



ALB 26 ALG 

tural changes in the kidney, affords evidence that the alhumen is owing to 
these changes, and that an organic renal disease exists, of a more or less seri- 
ous character. The greater the amount of the albumen, and the more 
abundant the casts and renal epithelium, or fatty cells, the stronger the indi- 
cation of the existence of kidney disease (acute or chronic Bright's disease). 
See Fig. 30. In the latter months of pregnancy and during the puerperal 
state the urine should be examined from time to time, to ascertain if albu- 
men be present ; for, whether it be due to passive renal congestion or to actual 
Bright's disease, its presence indicates the existence of one of the probable 
causes of puerperal eclampsia. 

Aloumiiiai-ia. A term applied to urine in which albumen is present, as 
is the case in Bright's disease of the kidneys, renal congestion, etc. — Arterial 
tension ascertained by sphygmographic traces of the pulse in scarlatina pre- 
vious to the appearance of albumen in the urine, while at the same time 
the characteristic crystalloid substances of the blood, especially hemoglobine, 
were found in it, has led M. Mohamed to consider these as the signs of the 
prealbuminuric stage. He has found them in certain conditions predisposing 
to albuminaria, as, at the commencement of alcoholic and lead poisoning, 
and during pregnancy. The presence of the crystalloid substances of the 
blood in the urine may be recognized by the blue coloration it assumes when 
two drops of ozonic ether and one of tincture of guaiac are added to this 
fluid. This coloration fails as soon as the albumen becomes abundant. 

Allmminimetre. A polarizing apparatus devised by Becquerel for the 
detection and estimation of albumen in the urine ; it is a modification of 
Mitscherlich's polarizer for the detection and estimation of sugar. The ana- 
lyser is not a Nichol's prism, but a birefracting prism, cut in such a manner 
that one image only is in the field of vision. To this analysing prism a lens 
is adapted, by means of which the examiner is the better enabled to observe 
the effects produced. It is seldom used on account of its expensiveness, as well 
as its inapplicability to urine containing small quantities of albumen. 

Albuminuric. A term applied to a person whose urine is albuminous ; 
likewise applied by some to the urine itself, or to the condition present 
occasioning the albuminaria. 

Alcohol coagulates or precipitates from their solutions, albumen, gum, 
dextrine, liquid starch, in white flakes and clots; the alcohol should be 
strong. It dissolves resins, volatile oils, and a certain quantity of fat oils. 
Physiologists generally suppose alcohol to be consumed during respiration, 
but Lieben has ascertained its presence in urine by the following process : 
Place the suspected liquid in a test tube with a few centigrammes of iodine, 
and a few drops of solution of caustic soda. Gently heat the mixture and a 
very characteristic precipitate of iodoform ensues. The ^oV o tn P art °^ alcohol 
may be detected by this process. 

Algae. Very fine filaments arranged in straight or waved clusters vari- 
ously crossing each other, and often forming a felt-like net-work so thick as 
to intercept the light and prevent their filampnto^a cfmrtnrp h^m beino- dip- 



ALK 27 ALK 

tinguished, except along the margins of this mass, consisting of Leptolhrix. 
With these filaments are constantly observed, included in their midst, or 
swimming very freely in the urine, a multitude of minute rods or wands 
(vibriones, bacteria, etc.). They may be studied in the coat or fur upon the 
tongue, especially in the morning, and in which they are found mingled with 
granular epithelial scales. In somewhat old deposits of alkaline urine, es- 
pecially when they contain mucus, they may also be found more or less 
masked by phosphates and urates, which a drop or two of acetic acid will 
cause to disappear. Alga? never exist in fresh urine. Other allied species of 
alga) are likewise found in putrefied urine, particularly Leptomitus. See Veg- 
etable Organisms. 

Alkaline Phosphates. See Phosphates. 

Alkaline Urine. This is commonly due to alkaline fermentation. Urine 
when just discharged is usually acid; it is rarely voided of an alkaline 
character, unless as the result of certain remedies taken inwardly, or when 
the urine is retained for a long time in the bladder. Healthy urine requires 
24 hours or longer to become alkaline, and which is due to fermentation ; 
but when the alkalinity occurs soon after it is passed, or within 24 hours 
afterward, some unfavorable condition exists which hastens the fermentation. 
During the fermentative process, the urea is decomposed, carbonate of am- 
monia is formed, as well as sulphide of ammonium, and the urine becomes 
of a fetid ammoniacal odor, and loses its transparency from the presence of 
bacteria, torula, and deposits of phosphates and urates. If acid phosphates 
are present in the fermenting urine, they become converted into neutral, and 
then into basic, phosphatic salts. The ferment is supposed to be decomposing 
mucus, pus, or other organic substances which act by catalysis upon the 
urea. This form of alkaline urine indicates some chronic affection of the 
bladder and urinary organs, or some malady of the spinal cord. Mucus, 
and other elements that by decomposition may act as catalytic bodies, may 
be removed from fresh urine by repeated filtrations, and then the urine will 
keep unchanged for a long time. However it is sometimes the case, when 
no morbid condition exists, that the urine is voided of a neutral or alkaline 
character, due to the use of acid fruits, certain foods, and medicine, or to the 
presence of an alkaline earth, or a fixed base of potash or soda ; the alkali 
existing in the blood to excess, which excess is separated and removed by the 
kidneys. This condition of the blood is the result of a long use of the alka- 
lies, either alone or combined with carbonic acid, or with vegetable acids ; 
it may also coincide with a general condition of weakness, defective nutrition, 
chlorosis, anemia, etc. 

An alkaline condition of the urine is determined by reddened litmus 
paper, which is restored to its original blue color. If, on drying the 
paper, or on gently heating it, the blue color disappears, and the red re- 
turns, the alkalinity of the urine is due to an ammoniacal salt; if it re- 
mains permanent, to a fixed alkali. See Chemical Reaction. Ammoniacal Urine. 
— Ammoniacal alkalescence changes the reddish-yellow color of logwood 



ALK 28 ALL 

paper to a dark violet. If a glass rod, moistened with hydrochloric 
acid, be placed in ammoniacal urine, white vapors are given off. Car- 
bonate of ammonia, in urine, gives effervescence when a dilute acid is 
added. 

Alkaloids. By agitating urine, which has been rendered alkaline, with 
chloroform, many alkaloids will be taken up by it. Agitate the chloroform 
solution with acidulated water, which removes the alkaloid. In this way 
may be detected aconitia, atropia, caffeina, cinchonia, codeia, conia, emetina, 
hyoscyamia, narcotina, nicotina, physostigmina, quinia, quinidia, strychnia, 
thebaina, theobromina, and veratria. Brucia, colchicia, or papaverina, dis- 
solve more slowly; narceina is taken up in only small quantity; sabadillia 
requires heat ; picrotoxin should be removed from an acid solution ; and 
morphia and solania are not removed at all by the chloroform. J. Nowah. — 
Phosphotungstic acid, as well as phosphomolybdic acid, precipitates alka- 
loids from their acid solutions ; filter and wash the precipitate, which may 
then be still further investigated. Schering. 

Alkapton. A peculiar substance found in urine by Bcedecker, which be- 
comes of a brown color when acted upon by an alkali ; it reduces the copper 
salts, but not those of bismuth, and does not undergo fermentation with 
yeast. 

Allantoin A substance met with in the urine of calves, and also stated 
to have been found in the urine of man, and that of dogs. It may be pre- 
pared by placing 100 grammes of uric acid in one or two litres of distilled 
water, which has been acidified with acetic acid ; to this is added the binoxide 
of lead, obtained from 1,500 grammes of minium. Expose the mixture for 
a time to the light without heating it ; lastly, heat to boiling, wash the resi- 
due on the filter with boiling water, and evaporate the filtered liquid. From 
30 to 32 grammes of allantoin are obtained. At first dialuric acid and urea 
are formed, then allantoin and oxalic acid. Mulder. Allantoin separates in 
colorless, prismatic, glass-like crystals, which are soluble in 160 parts of 
boiling water, in 30 of cold water, in boiling alcohol, but not in ether. It 
forms combinations with the oxides of lead, copper, and zinc ; and, under 
the influence of yeast, at 86° F., it is decomposed into urea, oxalate, and 
carbonate of ammonia, and a new syrupy acid. Mulder has combined it 
with nitric, sulphuric, and other acids. 

Alloxan. When 1 part uric acid is treated with concentrated nitric acid, 
sp. gr. 1.42, 4 parts, effervescence ensues, nitrogen and carbonic acid are set 
free, and a crystalline mass is formed, consisting of urea and alloxan; the 
latter being in colorless rhombic octahedra, which are disintegrated when 
exposed to atmospheric influence. The crystals are soluble in tepid water, 
have an acid reaction with litmus, and stain the skin purple. By evapora- 
tion the crystals may be obtained from their aqueous solution, in a state of 
greater purity. — When uric acid is dissolved in diluted warm nitric acid, 
alloxantine is formed in the solution ; on evaporating the solution almost to 



AMA 29 AMM 

dryness, and then adding nitric acid, alloxan is obtained, whch gives a deep 
purple color (murexide) with ammonia. 

Amanita Mnsearia. A fungus plant of the Agaric or Mushroom tribe, 
which is used by the Tartars to produce intoxication. Its intoxicating prin- 
ciple passes unchanged into the urine, imparting its intoxicating properties 
to this fluid. 

Ammonsemia. A term applied to that condition of the blood in which 
an excess of ammonia is present. In this condition the breath is ammonia- 
cal, as well as the perspiration ; and the urine is ammoniacal at the time of 
voiding it. This condition is due to a reabsorption into the blood of the 
decomposed products of urea, when urine is retained within the bladder 
for a long time. Ammonaemia is often curable by catheterization. See 
Uraemia. 

Ammonia. This alkali is employed in the same cases as soda and po- 
tassa, its action being a little less energetic. It is used to neutralize acids intro- 
duced into a fluid, to aid in the formation of certain ammoniacal salts, to 
distinguish leucocytes from epithelia, the former being rapidly dissolved by 
it, while the latter are not affected, or only become paler, and to dissolve car- 
mine. It renders vibriones and bacteria motionless without dissolving them, 
while it dissolves monads and spermatozoids. It is frequently employed in 
solution of full strength; but, for most purposes, a mixture of 1 part of 
the strongest liquor ammonia with 3 parts of distilled water, will be 
found of sufficient strength; it should be kept in a well stopped bottle. In 
addition to this, the following ammoniacal preparations are likewise em- 
ployed : 

1. Solution of Hydrochlorate of Ammonia. Take of pure hydrochlorate of 
ammonia 1 part, distilled water 10 parts (by weight). Mix, dissolve, fil- 
ter, and label, "Hydrochlorate of Ammonia. Detection of Lime in Presence of 



2. Solution of Molybdate of Ammonia. Take of pure molybdic acid 1 part; 
pulverize and place it in a porcelain capsule, or a glass balloon ; sprinkle 
and moisten it with pure liquor ammonia 5 parts. Heat gently, and agitate 
until the solution is completed. Then add, previously mixed together, the 
following: Pure nitric acid, 36°, 8| parts, distilled water 3f parts (all by 
weight). Agitate the whole together, and allow it to rest for some time in 
sunlight, or in a warm place, until a light lemon-colored precipitate is de- 
posited. Decant the colorless liquor, and preserve it in a well closed ground- 
stopper bottle ; label, " Molybdate of Ammonia. Detection of Phosphoric Add." — 
A quantity of this reagent must be employed, at least equal to that of the 
fluid in which the presence of phosphoric acid is sought, and should the pre- 
cipitate be tardy in appearing, gently heat it (104° F.). This is a very sensi- 
tive reagent; the only cause of error will be the presence of arsenic acid in 
the fluid, which precipitates moreover by the other reagents of phosphoric acid. 

3. Solution of Oxalate of Ammonia. Take of pure oxalate of ammonia 1 
part, distilled water 24 parts (by weight). Dissolve, filter, and label, " Oxa- 



r AMM 30 AMM 

late of Ammonia. Detection of Limey N. B. — The oxalate used must leave 
no residue when evaporated on a platinum spatula. 

4. Solution of Picro-Carminate of Ammonia. Take of Ammoniacal Solution 
of Carmine, q. s., and add it, drop by drop, to a saturated and filtered solution 
of picric acid in distilled water, until this solution becomes neutralized, or 
assumes the tint of gooseberry syrup. Any slight precipitate resulting from 
a commencing acidity may be removed by filtration. This solution colors 
the nuclei a delicate rose, and the rest of the cellule yellow. It likewise 
gives a yellow color to fibrin, mucus, and hyaline urinary casts. The color- 
ing only remains while the elements are in the picro-carminate; if water or 
acetic acid be added, the yellow color disappears. 

Ammonia in urine is passed in quantities varying from 5 to 13 grains in 
24 hours, equal to 19 or 36 grains of chloride of ammonium. To detect it, 
place 20 c. c. of fresh urine, filtered, in a glass or porcelain dish. Place a 
glass triangle across this dish, to support a smaller flat dish containing 10 c. 
c. of the standard sulphuric acid for this analysis. Place this on a ground- 
glass plate quickly, cover with a receiver, and hermetically close with tallow, 
having just previously added 10 c. c. of milk of lime to the urine in the 
lower dish. Set this aside for 48 hours. Now gradually add the standard 
solution of caustic soda for this analysis to the acid in the upper vessel 
(which has absorbed all the ammonia liberated), until this is neutralized. 
Every c. c. of this soda solution, less than its graduated standard, corresponds 
to 0.00715 gramme of ammonia. That is, if it requires 30 c. c. of the soda 
solution to exactly neutralize the 10 c. c. of sulphuric acid previous to the 
operation ; and, subsequently, it is found that only 26 c. c. of the soda 
solution have been used to neutralize, — the difference between the quantity 
required in the operation, 26 c. c, and that previous to it, 30 c. c. equals 
4 c. c, which corresponds with the amount of ammonia evolved and ab- 
sorbed. And, as 1 c. c. of soda solution equals 0.00715 gramme of ammonia, 
so 4 c. c. equals 0.0286 gramme of ammonia in the 20 c. c. of urine employed 
in the process. 1,000 grammes of this urine would then contain 1.43 
grammes of ammonia. — See Chloride of Ammonium ; Oxalate of Ammonia; Pur- 
purate of Ammonia ; Thionurate of Ammonia ; Urate of Ammonia; Sulphureted 
Hydrogen. Nessler's Test. 

Ammoniacal Urine. Freshly voided normal urine contains a small 
amount of ammoniacal salts; but urine is not considered ammoniacal unless 
it becomes neutral or alkaline within a short time after its discharge from 
the bladder, or while it remains in this organ before being passed. This is 
due to some morbid condition, as healthy urine usually requires about 24 
hours after its discharge before it becomes alkaline. See Alkaline Urine. 
Ammoniacal urine is fetid, pale, and turbid, and when permanent, is indica- 
tive of disease, as calculus in the bladder, catarrh of the bladder, paralysis 
of the bladder, ulceration of the bladder, prostatic enlargement, urethral 
stricture, disease of the spinal cord, etc. Pus is frequently present in this 
character of urine. Very minute quantities of ammonia may be detected 



AMM 31 ANA 

by a dilute solution of sulphate of copper, which occasions a greenish tur- 
bidity and precipitate of basic sulphate of copper. Solution of silicate of 
soda at the 100th, injected daily into the bladder, has removed the ammoniacal 
condition of the urine, and restored it to its normal state. See Nessler's Test. 

Aiiiiiioiiio-Mamncsiaii Phosphates. See Phosphates. 

Animonio-Oxirie of Copper. Ammoniacal Solution of Copper. Dissolve 
recently precipitated oxide of copper in liquor ammonia. This solution 
dissolves cellulose of cotton, flao; and hemp, but has no action on silk or v:ool. 

Am.vs-dalin. "When taken into the system, emulsin being absent, amyg- 
dalin does not produce hydrocyanic acid. Formic acid can be found in the 
urine after large does of amygdalin. 

Analyses of Urinary Sediments. The first step consists in completely 
separating the deposit it is desired to examine by filtration. The sediment re- 
maining upon the filter, whatever be its character, must then be washed with 
several drops or more of distilled water; a small quantity of it is then 
placed upon a platinum capsule, and heated in the flame of a spirit lamp. 
The following results may happen: — 1. The mass remains intact, and is not 
changed at a red heat. — 2. The mass turns black, swells up, and finally there 
remains a white residue permanent at a red heat. — 3. The mass chars, burns, 
and completely disappears. 

In the first instance, the sediment will be composed solely of inorganic 
substances unalterable at a red heat; indicating the presence of phosphate of 
lime, or magnesia, or carbonate of lime, or magnesia. Indeed, these are the only 
immediate principles that are insoluble in water, and unchangeable at a 
red heat. 

In the second instance, the deposit, whicli has only been partly decom- 
posed, may consist of urate of soda, potash, lime, or magnesia, oxalate of lime, or 
ammonio-magnesian phosphate, the only principles that may thus be precipitated 
and be partially decomposed at a red heat. 

In the third instance, a red heat causes the disappearance of the entire 
sediment, which may consist of uric acid, urate of ammonia, cholesterin, cysiin. 
margaric, or stearic acid, principles that are completely decomposed at a red 
heat. — Suppose the deposit belongs to one of these three groups, the analysis 
may now be proceeded with, granting, for greater simplicity, that it shall 
only contain substances belonging to the same order. 

The deposit remains unchanged at a red heat. Place a little of it, in a watch- 
glass or on a glass slide, under the microscope, and then moisten it with a 
drop of acetic acid ; if a large quantity of air bubbles are disengaged, visible 
through the microscope, carbonate of lime, or of magnesia, is present ; if no air 
bubbles are set free, it will then be phosphate of lime, or of magnesia. On add- 
ing to the solution of the carbonate or phosphate in the acid a few drops of 
oxalate of ammonia, there will be a precipitate if it is lime, and no precipi- 
tate if it is magnesia. 

The deposit is partly decomposed by heat. Place the precipitate in a watch- 
glass, add some distilled water to it, and boil it upon a water bath. If the 



ANA 32 APP 

precipitate dissolves, slightly concentrate the liquor, and place a drop of it 
on a glass slide, under the microscope. On cooling, crystals will be observed 
to form of, urate of potassa, soda, lime, or magnesia. As this examination of 
the crystals may not probably be sufficient, an ulterior examination may be 
had recourse to ; thus, to be certain that it is really a urate, some of the pre- 
cipitate is placed into a platinum capsule and moistened with nitric acid, — 
this is then dried over a spirit lamp, being careful not to burn the mass. 
When dried, let a drop or two of ammonia fall upon it, and if it be a urate 
under analysis, the whole will assume a magnificent purple color. 

To determine what urate it is, burn or calcine the mass a little, and then 
add a few drops of water to it; if it remains insoluble, it is magnesia, — urate 
of magnesia. If it dissolves, it is either soda or potassa. Place a drop of 
the solution upon a glass slide in the field of the microscope, and add to it a 
drop of chloride of platinum solution. If a yellow precipitate is formed,, 
composed of octohedral crystals, it is potassa, — urate of potassa; if no precipi- 
tate occurs, it is soda, — urate of soda. — If the precipitate (first obtained by 
partial decomposition under heat) does not dissolve when boiled in water, it 
is oxalate of lime, or ammonio-magnesian phosphate. ' Dissolve it in a drop of 
hydrochloric acid, then add a few drops of ammonia to it, to neutralize the 
acid added, if a precipitate reappears, examine it under the microscope, to 
determine from the form of the crystals, which of these two salts it is. 

The deposit completely disappears by the action of heat. Treat some of it with 
a little water, and then boil it; it is partially dissolved, for, on cooling, crys- 
tals of uric acid are precipitated, recognizable under the microscope. The 
experiment heretofore named for the determination of urates, may also be 
repeated, to-wit, the production of the purple color by the action of nitric 
acid and ammonia. If the deposit remains insoluble in the boiling water, 
but is soluble in boiling alcohol, forming crystals on cooling, it is cholesterin } 
margaric, or stearic acid, substances easy to determine under the microscope. 
See Fats ; Urinary Sediments. 

Anazoturia. A deficient amount of urea in the urine. 

Animalcnla Seminalia. See Spermatozoa. 

Antimony, Detection of in Urine. The process given for the detec- 
tion of arsenic in urine is the one to be pursued for the detection of anti- 
mony. The brilliant tint of antimony differs from that of arsenic, being of a 
more decided violet color, and the metal is less readily sublimed by heat, and 
the spots, instead of presenting a bright metallic lustre like those of arsenic, are 
dull. The deposit of antimony is with difficulty dissipated by the flame of 
a spirit lamp ; those of arsenic are readily driven off. The antimony stains 
are scarcely, if at all, removed when touched with a solution of hypochlorite 
of lime or of soda, while the stains of arsenic disappear at once. Again, the 
sublimate formed by antimony is amorphous or granular, and requires a 
more elevated temperature for its formation. 

Apparatus for Examining Urine. See page 16. 



APP 33 APvS 

Appearance of the Urine. In color, transparency, turbidity, and sediments. 
Which See. 

Araneosa Urina. Urine containing cobweb-like filaments. 

Ardor Urina?. A sensation of heat or scalding along the urethra during 
micturition, which is due to irritation or inflammation of the mucous mem- 
brane of the part, or to an unhealthy condition of the urine. 

Arcnosa Urina. Urine containing sandy or gravelly deposits. 

Arsenic, Detection of in Urine. Evaporate the urine to a small bulk ; 
strongly acidulate it with one-seventh or one-eighth its volume of pure 
hydrochloric acid, and then boil it. "While boiling introduce into it a small 
piece of freshly brightened copper foil or fine copper gauze, and continue the 
boiling for 15 or 20 minutes longer. If the copper becomes colored a metallic 
grey, fresh pieces should be added from time to time until the last one added 
presents no sensible change of color. Now remove the pieces of copper cov- 
ered with the grey deposit, wash them, and then dry them between folds of 
bibulous paper. The deposit readily adheres to the copper unless it be very 
thin, and presents a very distinct metallic brilliancy, of a steel-grey color, 
or, unless it forms a very thin layer, of a somewhat bluish tint. Under the 
influence of heat it completely disappears, and the copper resumes its ordi- 
nary aspect. Or, the pieces of tarnished copper foil or gauze may be placed 
in a perfectly dry glass tube, of as narrow diameter as possible, and which 
should be closed at one end, and loosely covered at the other. Upon applying 
heat to the part where the foil lies, there will be deposited at the cold part of 
the glass tube, a grey or dark metallic ring of arsenic, beyond which will be 
observed a white sublimate of arsenious acid, showing, under the microscope, 
cubic and octohedral crystals. — If no deposit forms on the copper, the urine 
(without removing the copper) should be still more concentrated* by boiling, 
and if no metallic tarnish be then observed, neither arsenic or antimony are 
present. 

This is a very simple process (Eeinsch's), and consists in precipitating 
metallic arsenic from its solutions by means of pure clean copper. As 
arsenic, by preference as it were, accumulates in the liver, from which it is 
not readily eliminated, in small quantities, it is always proper to concentrate 
the urine previous to testing it. 

2. Place pure zinc in a small flask containing distilled water acidulated 
-with sulphuric acid, then add some of the urine to be tested, and loosely stop 
the neck with cotton, so as to prevent any drops of the mixture from being 
thrown upon the test paper, which is to be held directly over the neck. The 
test paper is ordinary tissue paper moistened with a solution of bichloride of 
mercury, and used while moist. If arsenic be present a lemon-yellow spot 
will be formed on the paper, from the arseniureted hydrogen set free ; if an- 
timony be present, a brown spot. Pure hydrogen has no effect upon the 
paper. Mayenecm and Bergeret.. 

Arseniureted Hydrogen. This substance inhaled, causes the urine to 
become highly albuminous and black, from rapidly dissolved blood pigment. 
3 



ASP 34 AZO 

Asparagus. This article when eaten gives rise to a few crystals of oxa- 
late of lime, and imparts a peculiar unpleasant odor to the urine. In large 
quantity it is apt to occasion temporary glucosuria. 

Aspergillus Glaucus. Mucor glaucus. The blue mold on cheese, lard, 
and butter, and also found in urine. It has also been detected in the lungs 
and air cavities of birds. It may be known by its non-partitioned filaments, 
bearing at their extremities chains or rays of spores arising from a globular 
head at the apex of each fertile filament. This fungus may be studied upon 
preserved fruits and certain kinds of cheese. See Vegetable Organisms. 

Assafoetida. This article occasions a most disgusting odor from the 
urine. 

Atropia. A strong aqueous solution of bromohydric acid saturated with 
free bromine, produces a more or less bright yellow amorphous precipitate 
when added to a solution of atropia, which in a short time becomes converted 
into granules and short needle-like opaque crystals ; this precipitate is hardly 
soluble in caustic alkalies and the ordinary mineral acids, and is insoluble 
in acetic acid. Should the crystals become redissolved, a little more of the 
reagent will reproduce them. This will detect the a5 ^ 00 t h part of atropia. 
To detect this alkaloid in urine, first remove albumen, then to 10 c. c. of the 
filtered urine, add 4 or 5 drops of sulphuric acid, and 12 c. c. of strong alco- 
hol; agitate the mixture thoroughly, gently heat it for about 15 minutes, and 
when cold strain through fine muslin ; wash the residue on the muslin with 
alcohol, and strongly express it. Concentrate the strained liquid on a water 
bath, at a moderate temperature ; again strain ; evaporate to a small quan- 
tity ; filter ; add liquor potassa to render the filtrate slightly alkaline ; and 
then add twice its volume of chloroform to dissolve the liberated atropia. 
Allow the chloroform to evaporate spontaneously. To the residue add sev- 
eral drops of water containing a trace of sulphuric acid, and examine the 
solution by the above bromine reagent. If the residue is not sufficiently pure 
for testing, or in case no crystals are produced, again dissolve it in chloro- 
form, and proceed as before. The yellow precipitate, the peculiar crystals 
formed, and the dilatation of the pupils occasioned by a drop of the solution 
placed on the eye-ball, will be satisfactory evidence of the presence of atropia. 
Daturia, which is identical with atropia, gives similar reactions. In some 
cases, where the quantity of atropia present is very small, a larger volume of 
urine, say 20 c. c, will give more satisfactory results. 

Azoospermia. Partial or complete loss of the vitality of sperm atozoids. 

Azoturia. Excess of urea and other nitrogenous principles in the urine. 
As any functional lesion in which the organic combustions are executed too 
rapidly, from whence, general emaciation, and dryness, and roughness of the 
skin. Bouchard. 



BAC 35 BAB 



B. 



Bacteria. Minute vegetable organisms observed in decomposing urine, 
consisting of minute staff-shaped bodies, having a stiff", vacillating non-undu- 
latory motion, and a length of from .002 to .005 millimetres. See Vegetable 
Organisms. 

Balsam of Peru, as well as Balsam of Tolu, increase the amount of 
hippuric acid in the urine, or, occasion its presence, owing to the benzoic or 
cinnamic acid existing in them. 

Barium. Ba. Is the metallic basis of the earth baryta, or oxide of ba- 
rium. This agent, or its salts, are chiefly employed in the detection of car- 
bonic and sulphuric acids. The different forms in which it is employed in 
urinary investigations are the following: — 1. Baryta Water. Take of crys- 
tals of hydrate of baryta, 1 part; distilled water, 20 parts; mix, dissolve 
with the aid of heat, filter, and bottle. This water is used to precipitate mag- 
nesia, as well as to detect or remove acids which form insoluble compounds 
with it ; as, carbonic and sulphuric. Carbonate of baryta is entirely soluble 
in nitric acid ; sulphate of baryta is insoluble in this acid. — 2. Chloride of 
Barium Solution. (Barium Chloride.) For volumetric analysis of sulphuric 
acid in urine ; this is of two strengths, a. and b. a. Finely powder and then 
air-dry, crystals of chloride of barium, 30.5 grammes, and then add dis- 
tilled water to make the solution amount to one litre. Of this solution 1 c. 
c. will precipitate 10 milligrammes of anhydrous sulphuric acid. Bottle 
and label, " Strong Chloride of Barium. Detection of Sulphuric Acid." b. Of 
the preceding solution add 1 c. c. to 9 c. c. of distilled water. Of this solu- 
tion, 1 c. c. will precipitate 1 milligramme of sulphuric acid. Bottle and 
label, "Dilute Chloride of Barium. Detection of Sulphuric Acid." — 3. Chloride 
of Barium Solution, for detecting sulphates. Dissolve 1 part of Chloride of 
Barium in 10 parts of distilled water, by weight. Filter, bottle, and label, 
11 Chloride of Barium. Detection of Sulphates."— 4. Baryta Solution. Mix to- 
gether 2 volumes of a saturated baryta water and 1 volume of a saturated 
solution of nitrate of baryta, at the ordinary atmospheric temperature. 
This is used to precipitate the phosphates from urine, when examining it for 
chlorides, etc. Bottle and label, " Baryta Solution. Precipitation of Phosphates." 
The addition of an equal amount of distilled water to this solution forms 
the Solution of Baryta for the analysis of urea by Liebig 1 s process. 

Barreswill's Liquor. This fluid is often used in the examination of 
urine for sugar, but on account of the difficulty of preserving it, requiring 
it to be freshly prepared each time it is to be used, Fehling's and Pavy's 
modifications of it are preferred. It is made as follows, the quantities in 
parenthesis being from Beale : Take of cream of tartar, pure, 5 grammes 
(96 grains), crystallized carbonate of soda 4 grammes (96 grains), pure sul- 



BAE 36 BIL 

phate of copper 3 grammes (32 grains), caustic potash 4 grammes (64 grains), 
distilled water, a sufficient quantity to complete the volume of 100 c. c. (2 
fluidounces). Dissolve the cream of tartar in some of the water by heat; 
pour this boiling solution into a solution of the sulphate of copper ; then add 
the potash and the soda, and, lastly, enough distilled water to make 100 c. c. 
Of this reagent, 1 c. c. is decolorized by 1 centigramme of glucose. To use 
the fluid as made by Beale's formula, place equal bulks of urine and the 
fluid in a test tube, boil the mixture, and if sugar be present, a red precipitate 
of suboxide of copper ensues at once. 

Barnria. Urine having great specific gravity. 

Bas Fond. The most inferior portion of the bladder. 

Benzamide. When hippuric acid is acted upon by oxidizing agents, as, 
peroxide of lead in water, it is decomposed into water, carbonic acid, and 
benzamide, which is soluble in alcohol. 

Benzoate of titnia. Lithiac or Lithium Benzoate. Lithium Benzoicum. 
Lithium forms a soluble salt with uric acid ; and benzoic acid being trans- 
formed into hippuric acid in the organism, forms a soluble hippurate of lime 
(calcium hippuricum). Benzoate of lithia forms a light, white powder, 
soluble in water, and which has been of service in the removal of urate of 
lime in gout. 

Benzoglycolic Acid. When hippuric acid is acted upon by hyponitrous 
acid, or when a solution of hippuric acid in nitric acid is exposed to the in- 
fluence of a current of nitric oxide, nitrogen is evolved, and benzoglycolic 
acid crystallizes in the form of colorless prisms, which are readily soluble 
in alcohol and ether, sparingly soluble in water, and form neutral salts with 
one base. 

Benzoic Acid, When taken internally, this acid is eliminated as hippuric 
acid in the urine. It has consequently been administered in ammoniacal 
urine with success, as follows: Take of benzoic acid 1 to 3 parts, neutral 
glycerin 3 to 4 parts, mucilage 150 parts; mix. Dose of the mixture 1 
gramme daily, quickly carried to 4, 5, or 6 grammes per day. In this mix- 
ture the benzoic acid is held in suspension. It forms a hippurate of 
ammonia which is less poisonous than the carbonate ; increases the acidity 
of normal urine ; retards the decomposition of the urine and the consequent 
formation of the ammoniacal carbonate; and prevents the formation of in- 
soluble phosphates, which give rise to cystitis, and calculus. 

Bile in Urine. In certain pathological conditions of the body, bile is 
detected in the urine in the form of bile pigments, or bile acids, each of which 
must be searched for separately. Urine in which the biliary pigments or 
coloring matters are present, has a peculiar greenish-yellow, or dark-brown 
tint, and stains linen yellow. If the urine be shaken the froth will be yellow, 
and if the fluid contain anatomical elements, as, epithelia, pus, urinary cyl- 
inders, etc., these will likewise have an intense yellow color. Phosphatic 
sediments are frequently encountered in urine containing bile, which is often 
alkaline at the time it is voided. Sometimes, but not invariably, the crystals 



BIL 37 BIL 

of ammonio-magnesian phosphate, are colored yellow. As the bile acids 
are seldom found in the urine, testing for the pigments is usually deemed 
sufficient. See Coloring Matters of Urine. 

Bile Acids. These acid-, in the urine, are, taurochloric, glycocholic, and 
their derivatives; they are rarely detected in the urine of icteric patients, but 
have been observed in this fluid in acute yellow atrophy of the liver, and in 
pneumonia, without the coexistence of the bile pigments. The cause of the 
presence of the bile acids in urine is but illy understood. 

Detection of Bile Acids. For this purpose Pettenkofer's test is the one 
generally recommended, but it is tedious, troublesome, and, for the general 
practitioner, impracticable. Beside which it may lead one into error, because 
albumen, as well as several essential oils, give an analogous reaction; there- 
fore, Avhen albumen is present it must first be removed by coagulation and 
filtration. 

1. Hoppe's modification of it renders the process very reliable, but does not 
diminish its tediousness. It is as follows : Caustic ammonia is to be added 
to the urine until it is faintly ammoniacal, and then treat with diacetate of 
lead as long as any precipitate occurs. Wash the precipitate collected on a 
filter, with distilled water ; boil it with alcohol over a water bath, and filter 
while hot. Add a few drops of potash or soda to the filtrate, and evaporate 
the solution, over a water bath, to dryness. Again boil the residue, over a 
water bath, with absolute alcohol, continuing the evaporation until only a 
small quantity remains. Shake this with ether in a stoppered bottle, and after 
some time the alkaline salts of the bile acids will separate in crystals. These 
may now be verified by Pettenkofer's test, thus : Dissolve these crystals in a 
little distilled water, and place the solution in a porcelain capsule ; a drop 
or two of saturated solution of cane sugar must now be added, and then treat 
the mixture by dropping strong sulphuric acid into it, in excess of the amount 
of bile acid present, or about a volume equal to that of its solution. Apply 
moderate heat, a beautiful cherry red, succeeded by a deep purple color, is 
formed, the latter being the characteristic reaction when bile acids are pres- 
ent. See Cholic and Cholinic Acids. 

J 2. Neukomni's modification of Pettenkofer's test is very simple and exact. 
Prepare a solution of pure sulphuric acid 1 part, distilled water 4 parts ; also 
a solution of cane sugar 1 part, distilled water 4 parts. Place a small por- 
tion of the urine in a porcelain capsule, or watch glass, and slowly and gently 
heat it over a water bath or spirit lamp, until but a few drops remain, to 
which add a drop or two of the solution of sulphuric acid, and then a drop 
of the saccharine solution. If biliary acids are present, the beautiful purple- 
violet color characteristic of Pettenkofer's test will appear at the border of 
the evaporated fluid. Bischoff states that this reaction does not occur with 
albumen or fat, but only in presence of the bile acids. Care must be had, 
in the above process, not to evaporate too rapidly, as it will give rise to the 
formation of black matters, masking the reaction. If a yellow color ap- 



BIL 38 BIL 

pears, the acid is acting on the sugar, and the desired reaction will not take 
place. 

3. M. Strasburg, of Bremen, has given another modification of the pre- 
ceding test, but it is imperfect and unreliable. 

4. M. Medin has given a process by which both the biliary acids and pig- 
ments may be determined in one operation : Fifteen c. c. of the suspected 
urine are rendered alkaline by the addition of two drops of caustic soda so- 
lution, to which chloride of barium solution is added as long as a precipitate 
occurs. Then, the liquid is boiled on the precipitate, and filtered while boil- 
ing hot. The almost colorless filtered liquid is carefully neutralized by 
hydrochloric acid so as to leave it still slightly alkaline, when it is to be agi- 
tated with 4 or 5 c. c. of amylic alcohol. If the liquid presents an emul- 
sive aspect, as often happens, the addition of a small amount of ordinary 
alcohol will remedy it. The amylic alcohol is now to be removed by means 
of a pipette, and evaporated to dryness. The light-colored residue thus ob- 
tained gives a beautiful purple-violet color, when heated with a trace of 
sugar and sulphuric acid, if bile acids were in the urine. Care must be had 
to completely volatilize the amylic alcohol before using the other reagents, as it 
alone will give a fine red color with sulphuric acid, which becomes still more 
beautiful when a trace of cane sugar is added to it. Urine containing a 
millionth part of bile will, by this process, give distinctly the reaction with 
Pettenkofer's test. 

By washing the barytic precipitate with distilled water, then treating it by 
sulphuric acid and alcohol, with heat, a fine green color will be formed if 
bile pigment be present. 

X 5. A very decisive and characteristic reagent for the detection of bile or 
bile acids, and which is not influenced (as to color) by the presence of sugar 
or albumen, is Methylaniline or Paris violet, 1 part dissolved in 500 parts of 
distilled water. A few drops of this solution added to normal urine renders 
it dichromatic ; blue by reflected light, and violet by transmitted ; but if bile 
be present, the urine assumes a blood-red color, with an abundant precipitate. 
The bile pigments, or cholic acid give, each, a precipitate, but no change of 
color. As chrysophanic acid is the only substance giving a like reaction 
with this reagent, the practitioner must ascertain whether the patient has 
taken rhubarb or senna, within 12 or 15 hours previous to passing the urine 
examined, before ascribing the change of color to bile. M* Yvon. 

Bile Pigments. These coloring matters are: 1, cholepyrrhine, brown pig- 
ment, also termed bilifulvine, biliphseine, bilirubin, and cholophseine ; 2, 
biliverdin, green pigment, cholochloine, cholochlorine. The first named is the 
one more commonly present in the urine, and which is often converted into 
the latter. These pigments maybe temporarily present in the urine in small 
quantities, during hot seasons (the same as we observe at this period of the 
year, a slight yellowish coloring of the sclerotica of many persons); but they 
are in greater amount and more marked in the urine of jaundiced patients. 
They may be present with or without the coexistence of the bile acids or 



BIL 39 BIL 

their salts. The detection of the coloring matter of bile in the urine is 
seldom useful, except in doubtful cases, as jaundice is generally recognized 
by other symptoms. The coloring of the teguments is shown shortly after 
the appearance of the bile pigments in the urine ; but it persists when these 
have disappeared. In jaundice, biliverdine and biliprasine predominate in 
the urine ; the latter is biliverdine plus one atom of water. It is probable 
that this transformation occurs in the blood itself, because this substance is 
not a product of the normal secretion of the liver. Hardy states that if 
cholepyrrhin be injected into the veins, jaundice is produced, and biliprasine 
is found in the urine. — If the urine to be examined for bile pigment be of 
too dark a color, it should be rendered lighter by the addition of sufficient 
distilled water, previous to applying the tests. 

Detection of Bile Pigments. % 1. Into the clear urine pour some ordinary 
acetic acid ; if these pigments are present, 'persistent green color appears 
which is darker in proportion to the greater amount of biliary coloring mat- 
ter in the urine. — This is a very distinct reaction, and should be preferred 
to that with nitric acid. Indeed it is quite as sensitive, gives no play of col- 
ors, and remains for a long time, while the coloring determined by nitric 
acid is very fugaceous, especially when there is but little bile pigment. Be- 
sides, nitric acid has the inconvenience of giving analogous reactions with 
many organic compounds that may accidentally exist in the urine, indican, 
etc., also alcohol, essential oils, and many alkaloids. — % 2. Spread a thin 
layer of urine over a white porcelain or china plate, and let one drop of 
turning nitric acid (nitroso-nitric acid) fall upon the center of this layer, a 
series of colors will be alternately and rapidly produced, and which will ex- 
tend towards the circumference of the urine in the following order : Green, 
blue or violet, ruby-red or yellowish-red. (If the urine be albuminous, the 
same result may be obtained by letting the urine fall drop by drop upon 
some hydrochloric acid.) The green color is the characteristic one, the oth- 
ers may be obtained from the pigments common to the urine, and the whole 
of them do not always appear. Indican in urine will give a blue or violet, 
and even green, color with nitric acid, as is often the case in melanotic can- 
cers, in which the urine is frequently a. dark brown. Gmelin. Biliverdin 
in urine does not give the same reaction as cholepyrrhine, but gives the green 
color immediately with hydrochloric, sulphuric, or acetic acid, without the 
changes produced in cholepyrrhin by nitroso-nitric acid. — A. Hilger ob- 
serves, however, contrary to what has generally been stated, that he has 
found all the biliary coloring matters to give the characteristic color changes, 
— green, violet, blue,— upon the addition of nitroso-nitric acid. — M. Caze- 
neuve states, relative to Gmelin's process, that there may exist an error in it 
if the suspected urine contains any alcohol. In a mixture of nitric acid and 
alcohol, the nitric acid is converted, by the alchohol, into nitrous acid and 
an immediate formation of highly volatile nitrous ether, no coloration being 
effected. But if the acid be allowed to flow slowly down the side of a test 
tube containing alcohol, it will pass to the bottom, and the reaction between 



BIL 40 BIL 

the two fluids will slowly take place. In about a minute or so, a splendid 
greenish-blue zone will appear, having a yellowish-green zone below it, and, 
in a few seconds, a reddish zone above it. When the alcohol has become 
etherized, all coloration disappears. — 3. Into a small beaker glass pour about 
6 c. c. of pure hydrochloric acid, and add to it, by drops, just enough of the 
urine to slightly but distinctly color it. Mix the two, and then by means of 
a slender glass tube, funnel shaped at its upper extremity, drop in some pure 
nitric acid so as to form a layer beneath the fluid, or, this acid may be al- 
lowed to trickle down the side of the inclined glass to its bottom ; the play 
of colors, above named, will take place at the point where the acid is in con- 
tact with the mixture. If the nitric acid be now agitated with a glass rod, 
the colors will appear by the side of each other. When the urine is added 
to the hydrochloric acid, it will be colored green if biliverdin be present, 
and reddish-yellow if it be cholepyrrhin. Heller. — % 4. A most sensitive re- 
agent is found in ordinary tincture of iodine. Two or three drops of this 
tincture let fall upon a small quantity (3i) of icteric urine in a test tube 
produces a magnificent emerald-green color, which remains about half an 
hour or longer, then becomes red, and finally yellow. When the urine is 
alkaline a few drops more will be required. This green color has been pro- 
duced in a mixture of a few drops of icteric urine with distilled water 60 
grammes (2 fl oz.). In case of a very feebly bilious urine, we should also 
act comparatively upon a normal urine at the same time, to render the dif- 
ference of the tints more evident. The reaction will be more striking if an 
albuminous water be added to it, which will give a green precipitate ; or, a 
solution of subacetate of lead, which will give a yellowish one. Marechal. 
In this process the iodine tincture must not be allowed to mix with the 
urine, but to trickle down along the side of the test tube held nearly hori- 
zontally. The green color will be seen beneath the red layer of tincture of 
iodine, which must not be too strong lest the test fail. A very dark colored 
urine should be diluted with an equal volume of distilled water previous to 
applying the test. If the above rules be observed, the test will not fail in a 
single instance of bilious urine, and is fully as delicate as any other test now 
known. — 5. Biliverdin is not separated from urine by chloroform, being in- 
soluble in this agent, though its presence may, however, be revealed by the 
processes with the acids. Cholepyrrhine is soluble in this agent, the least 
quantity in the urine being separated frcm it; and this reaction gives a 
special process for detecting the latter pigment, when there are merely slight 
traces of it in the urine. Successively agitate, with some chloroform, several 
large quantities of the urine, being careful each time to allow the chloroform 
to settle, and then to draw off the supernatant urine. The chloroform sinks 
to the lower strata, and assumes a yellowish color from the presence of the 
pigment in solution, and a milky aspect due to the agitation. When this 
yellowish tint is sufficiently marked, the urine is drawn off for the last time. 
Now place a drop of the chloroform solution upon a glass slide, and allow it 
to dry. If cholepyrrhine be present, the residue will, when examined under 



BIL 41 BLO 

the microscope, be found to consist of reddish-yellow crystals, which, moist- 
ened, under the microscope, with fuming nitric acid, will give changes oi 
color, green, blue, red, violet, and yellow. The objective should be protected, 
or a chemical microscope be employed, as the nitric acid vapors injuriously 
affect the brass of the objective. Alkalies dissolve these crystals. — We may 
likewise simply pour some fuming nitric acid upon the chloroform solution, 
and observe if the required colors are produced. Valentiner. — Bitter states 
that he has discovered a blue coloring matter in bile. 

Uilliarzia Hiematobia. Distoma Haematobium. A parasitic entozoon 
common in Egypt, Cape of Good Hope, and some other hot countries, and 
first discovered by Bilharz, in Egypt. It is found in the intestines, in the 
bladder, in the ureter and pelvis of the kidney, producing very serious re- 
sults. The frequency of fatal dysentery, calculous affections, hasmaturia, 
etc., to which the inhabitants of these countries are subject, are supposed to 
be mostly due to the presence of these worms in the urinary passages. 

Bilifulviu. See Bile Pigments. 

Biliprasin. See Bile Pigments. 

Bilirubin. See Bile Pigments. 

Biliverdin. See Bile Pigment's. 

Blood in Urine. (See Coloring Matters of Urine.) Urine may be mixed 
with blood corpuscles, which are known by their elements and distinctive 
characters; or, it may simply be tinged by the coloring matters of the blood, 
— the blood may be discharged from any part of the urinary-renal tract. 
It must be remembered that blood may likewise be found in the urine of 
women, of uterine or vaginal origin; and that it is likewise mixed with 
urine occasionally by the subjects themselves for purposes of deception. If 
from the kidneys, in small quantity, the urine being acid, the blood is dif- 
fused through this fluid, imparting to it a dark brown or smoky appearance. 
(See Hematin.) If the urine has an alkaline reaction, it will present a bright 
red color, like blood. Large quantities of blood in the urine may be knoAvn 
by the blood red color of this fluid, the coagula formed, and the brownish-red 
deposit; albumen will likewise be present in proportion to the amount of 
blood existing in the urine, and which is derived from the serum of the 
blood. The microscope affords the most ready and certain method of detect- 
ing blood in the urine, especially if this examination be made soon after the 
liquid has been passed. In some cases the corpuscles may be found perfect 
for several days, as when the urine is acid; but they sometimes decompose 
very speedily, especially if the urine be of low specific gravity, or ammonia- 
cal, when they swell, and finally rupture from endosmosis; when the sp. gr. 
is high, they frequently contract, shrivel, and become distorted in various 
ways (crenated, etc.), from exosmosis. As the urine containing blood readily 
becomes alkaline if it be desired to test it for albumen, it must first be ren- 
dered acid by the addition of acetic acid. % Under the microscope, blood 
corpuscles will be observed non-nucleated, or entire, smooth, flat, non-granu- 
lar, yellow or reddish-brown, and either detached or adhering in nummular 



BLO 



42 



BLO 



form; the discs being biconcave, a change in focussing will give a dark cir- 
cumference and a light center, or the reverse of this ; and, if the fluid con- 
taining them be set in motion, so as to move the corpuscles, their biconcave 
form will be at once observed. The diameter of human blood corpuscles is 
constant, averaging about Omm .0075; that of the dog, mm .00716; of the 
hog, mm .006 ; of the horse and ox, mm .0056 ; of sheep, mm .005 ; of 
the rabbit, mm .0069, etc. (See Fig. 22, page 129, Microscopic Appear- 
ances of Blood.) It may be proper to state that Prof. Fairfield, of the New 
York College of Veterinary Surgeons, who has been making careful examin- 
ations of blood corpuscles, has recently expressed doubts as to their disc-like 
form and biconcavity, which appearances he considers the result of the under 
correction of the microscopic lenses of the more powerful microscopes. He 
defines these corpuscles as being perfectly spherical bodies, containing inter- 
nally a colorless protoplasm, and externally a thin coat slightly stained with 
coloring matter. 

V. Table. 



A. On cool- 
ing, the urine 
has a blood- 
red color. 



B. On cool- 
ing, the urine 
is reddish- 
brown, black- 
brown, or ink- 
black. 



I. 

ent. 



It is transpar- 



% Detection. 



a. Add a few 
drops of hydro- 
chloric acid. 



II. It is slightly- 
turbid. 



III. There is 
red sediment. 



IV. It is not sedi- 
mentary, and the 
microscope shows 
no blood corpuscles 
in it. Boil the urine 
alone, or with a lit- 
tle acetic acid. 



< cipn 

( this 



i. The color 
becomes dark- 



2. The color 
becomes clear- 



Allow it to rest until a pre- 

ipitate forms, then examine 

precipitate.... , 

c. Observe under the micro- 
scope whether this precipitate is 
crystalline or amorphous ; on 
heating it in a test tube it be- 
comes dissolved. 

d. The microscope shows blood 
corpuscles; the precipitate is not 
soluble by heat. 



e. Formation of a reddish-brown 
coagulum. 



Coloring mat- 
ters of the 
blood. See B. 

Foreign color- 
ing matters. 
Rhubarb, etc. 



According to 
III. 



Urates; Uric 
Acid. 



Blood. 



Coloring mat- 
ters of the 
blood. (He- 
mato- globulin 
and products 
of decomposi- 
tion. 



If we represent the average diameter of the blood corpuscles of man by 7, the 
globules of blood of other animals maybe represented as follows: — Elephant, 
9; dog, 7; rabbit, 6 ; horse, 5; sheep, 5 ; goat, 4; guinea pig, 2. The blood 
corpuscles of all mammiferous animals present circular disks under the 
microscope, with the exception of the llama and camel family, whose glob- 
ules are elliptical, but always without a nucleus. The blood corpuscles of 
birds, are generally twice larger than those of man, and may be represented 
by 15 ; they are elliptical, biconvex, presenting a more or less distinct 
nucleus. The globules of reptiles and of amphibious animals are still larger 
(represented by 20 for those of the frog) ; they are still more elliptical, more 



BLO 43 BLO 

convex, and with a very distinct granulous nucleus. The blood corpuscles 
of fishes may attr in very large proportions ; they usually present the same 
characters, with a few unimportant exceptions, as far, at least, as concerns the 
present subject. — White globules in human blood are spherical, about a third 
larger than the red, represented by 9£, and present when in a neutral vehicle, 
a pale, granulous appearance, irregular outline, and a characteristic silver- 
white color. The addition of water causes them to swell, to present a smooth 
outline, with Brownien movements among the internal granules, and single, 
double, or multiple nuclei, which are rendered more distinct by the addition 
of a little aretic acid. In the healthy adult, there is about 1 white globule 
to every 350 red ones, the blood being taken from the skin ; but food, exer- 
cise, disease, etc., may greatly augment the number of the white corpuscles. 
A very excellent instrument has been devised for counting the blood globules 
under the microscope. It is termed Hematimetre, of Hayem and Nachet, and 
is manufactured by Nachet. optician, Paris, France. A. quadrillated ocular 
is necessary when using this instrument. It has been ascertained that the 
number of corpuscles in a drop of blood are temporarily increased when the 
serum of this fluid is subtracted by any morbid or therapeutical cause, as by 
purgation, diarrhea, obstinate vomiting, excessive perspiration, etc.; conse- 
quently, when counting the number of corpuscles by the Hematimetre, 
the proportion of the serum in which they are found should be taken into 
consideration, otherwise, the count may give a plethoric indication when 
there is only feebleness and exhaustion. — The presence of blood in urine 
or other fluids is readily determined by spectral analysis; but the positive 
determination of human blood in spots or stains has not been satisfactorily 
demonstrated. See Micro- Spectroscopy. 

A. The preceding table will at least be found practical, though probably 
not perfect. When blood imparts a blood-red color to urine, a greater or 
lesser quantity of blood globules will be found present. If the color be 
brown or smoky, the method B may be required, because the globules are apt 
to be more or less dissolved or destroyed ; the commencement of this decomposi- 
tion occurring either in the bladder or after the urine has been voided. — A. I. 
Urine colored blood red by dissolved Jiemato globulin, contains no blood cor- 
puscles, consequently, in addition to the test by hydrochloric acid, that 
according to B must also be pursued. — The foreign articles which color urine 
red, so as to lead to a suspicion of the presence of blood, are numerous and 
often unexpected. — A. II. When the quantity of blood is quite small, the 
urine will present only a slight turbidity ; in such cases, the urine should be 
allowed to rest for some time in a conical-shaped test glass, until the cor- 
puscles become deposited at the bottom of the fluid. These, especially in 
warm weather, are liable to rapid decomposition, consequently the deposit 
must be examined as soon as it begins to form. — A. III. The more or less 
deep-red sediment, accompanying a blood-red urine is not rare in chronic 
affections of the liver (cirrhosis), and in the last stage of cardiac affections 
(affections of the mitral orifice). This sediment composed of urates and a 



BLO 44 BLO 

little uric acid, is clearly determined by its microscopic characters, its solu- 
bility by heat, or by the addition of an alkaline solution. Should earthy 
phosphates be present, they will not dissolve by heat, nor in alkaline solu- 
tion, and are readily distinguished under the microscope. As to the urine 
itself, should it contain albumen, albumin aria may be present. — d. When this 
red sediment consists of blood, the microscope will reveal the characteristic 
corpuscles, and which examination should be made at as early a period as pos- 
sible. — B. This peculiar coloring may be present in the urine when it contains 
blood, either in a natural state, when a commencing decomposition has oc- 
curred, or, when it contains only the coloring matter of blood, hsematoglobin, 
which decomposes, and gives, upon boiling it with acetic acid, hsematin and 
albuminoid substances which coagulate. This reddish-brown coagulum, when 
dried and powdered and boiled in alcohol containing sulphuric acid, renders 
the fluid red or reddish-brown, if hsematin be present. From this experi- 
ment it may be concluded that the urine contains the coloring matters of the 
blood in solution. 

Reactions. Water added to blood corpuscles causes them to swell and 
assume a spherical form, and if the action of the water is prolonged, their 
coloring matter is abstracted, and they become pale, softened, completely 
vesiculous and transparent, and soon disappear under ordinary magnifying 
powers. Now, if a drop or two of a concentrated solution of sulphate of 
soda be added, the corpuscles again become visible, but are deformed, more 
or less angular, dentated, etc. — A solution of an alkali at ^th rapidly dis- 
solves the globules. A concentrated solution does not dissolve them, but 
causes them to greatly diminish in size. — Acetic acid at j^th ordinarily renders 
blood corpuscles pale, and so faint as to be barely perceptible. — Nitric acid 
shrinks the corpuscJjes, and colors them greenish.— Coloring reagents, as well as 
coloring matters, are without action upon them. Bile dissolves them. 

$ Prof. Almen gives the following process [Prof. Van Deen's] for detecting 
blood in urine: Mix tincture of guaiac 2 c. c. with an equal volume of oil 
of turpentine, in a test tube, and agitate until an emulsion is formed. 
To this carefully add a little of the urine to be tested, so that it may sink to 
the bottom. As the two fluids come in contact the guaiac resin separates and 
forms a white, dirty yellow, or green precipitate ; but if blood be present, the 
resin will have a more or less intense indigo-blue color. This is a simple 
and reliable method, and is so extremely delicate as to produce the reaction 
with one twenty-thousandth part of a milligramme of iron, according to T. 
Schiellerup, of Copenhagen; and hence requires great care and judgment as 
a test in legal cases. 

Clinical Import. Urine which contains blood corpuscles, likewise contains 
fibrin and albumen, these substances being integrant parts of the blood. 
When a quantity of fibrin, or albumen, is found in the urine, not in propor- 
tionate relation with the amount of blood in this fluid, it may be decided 
that there has been an exudation of fibrin, or of albumen. Blood contained 
in the urine indicates that a hemorrhage has occurred at some point of the 



BOD 45 BRO 

urinary apparatus. It must, however, be borne in mind, that with women, 
blood is frequently found in their urine during menstruation, and, when me- 
trorrhagia is present. — If, in addition to the blood corpuscles, urinary casts 
or cylinders arc also present, renal hemorrhage may be suspected. (See 
Renal Tube Casts. Blood Casts.) Small clots of blood are sometimes observed 
in a slightly-colored urine, which may be due to small intermittent hemor- 
rhages from the surfaces of the vesical mucus membrane, or from the ure- 
thral surface, or they may be formed in the ureters, from which they are dis- 
charged with more or less severe pain. Decomposed blood is sometimes 
of serious import, for a reference to which, see Haimato globulin. 

The diseases in which blood is found in the urine, are, acute Bright's dis- 
ease ; congestion of kidney ; cancer of kidney ; tubercle of kidney ; external 
injury to the kidney; calculus in pelvis *and ureter; bilharzia hsematobia; 
pyelitis ; cancer of the pelvis and ureter ; diseases of the bladder, and of the 
urethra; certain constitutional diseases, as, scurvy, purpura, etc.; stimulating 
diuretics; mechanical violences, etc. See Table XXII, which may aid in the 
diagnosis of the source of the blood met with in urine. 

Bono Urinarius. An animalcular organism sometimes observed in the 
urine, and first pointed out by Hassall. This animalcule is oval and round, 
often broader at one end, furnished with one or more cilia, about xsV o^h of 
an inch in length and T -^ w th of an inch broad, granular, and resembling a 
leucocyte or mucus corpuscle. It increases by division. It is found in 
albuminous urine. I have seen it in the urine of excessive drinkers of 
lager beer. 

Bradysuria. Painful micturition, with incessant urinary tenesmus. 

Bright's Disease. A term applied to several forms of kidney disease, 
characterized by the presence, in the urine, of albumen and urinary casts. 
The disease was first described by Dr. Eichard Bright, of London ; there are 
two forms of it, the acute and chronic, which are subdivided into several 
varieties. It is seldom curable, more commonly occasioning death. 

Bromide of Potassium in the Urine. It is very probable that nearly, 
if not quite, all of this bromide taken into the stomach is eliminated through 
the urine. The quantity of bromide may be determined by means of a 
titrated solution of hypochlorite of soda placed in a burette. Acidulate the 
urine by citric acid, and sulphuret of carbon will take up the bromine ab- 
stracted by the nascent chlorine. Coigniet.—k. method of detecting a bromide 
in the urine has been given as follows: Acidulate the urine with nitric acid, 
and then add argentic nitrate to precipitate the mixed chlorides and bro- 
mides. Wash this precipitate, and when dry fuse it with a mixture of chem- 
ically pure carbonate of soda and potassa — that prepared by igniting Rochelle 
salts is better than the commercial carbonate. Dissolve the mass in a little 
water, add enough hydrochloric acid to neutralize the solution, and filter into 
a clear test tube of white glass. Another similar test tube is filled to the 
same height with a weak solution of chloride of sodium. Into each liquid 
let fall one drop of a solution of chloride of gold, and agitate. If any bro- 



BKO 46 BUT 

mide be present, on comparing the two fluids side by side, the first one will 
present a yellowish tint throughout, even if only slight traces of bromide 
exist. If an iodide be also present, it will interfere with the reaction, and 
should be separated, first, by palladium, and the palladium by sulphydric 
acid. J. H. Bill, M. D. 

Bromine, and Iodine in the Urine. Cut a leaf of brief paper into 
small strips, and introduce one of them into the test tube or beaker glass 
containing the urine, letting its inferior extremity touch the bottom of the 
vessel. Then drop, so as to flow along the side of the glass, three or four 
drops of nitric acid. In a few minutes, upon removing the paper, a more or 
less dark, fine blue color will be observed at the inferior extremity of the 
paper, if iodine be present; or, a well marked orange-yellow, if bromine. 
Ordinarily, iodine is more readily detected in the urine in two or three hours 
after its administration. After having dropped the acid, at least ten minutes 
must be allowed for the blue tint to become manifest. Care must be taken 
to so drop the acid that it may run along the side of the glass vessel and col- 
lect at the bottom. An error must always be suspected, caused by the trans- 
parency of the paper impregnated with the transparent fluid, manifesting 
itself by a blueish tint. 

Brownian Movements. Brunonian Movements. Molecular Motion. These 
terms are synonymously applied to a perpetual, more or less active, agitation 
among the molecular granulations floating in liquids, as observed under the 
microscope. These granulations vary in size, but are usually less than the 
five or six thousandth of a millimetre in thickness. Robert Brown, a botan- 
ist, first made known, in 1827, that finely powdered metals, stones, and even 
charcoal, when treated by acids and heat, presented this agitation, as long as 
they remained floating in the liquid. These movements are especially seen 
in the fovilla-grains of pollen, in certain diatoms and desmids, in the gran- 
ules resulting from the decomposition of leucocytes and infusoria, in the 
organites (elementary bodies) so termed, of certain contagious maladies, etc. 
They generally present vibrating, oscillatory, or top-like spinning move- 
ments, and may become displaced four or five times their diameter in one 
direction, and then in another, without making any progression. Previous 
to Brown's experiments they were erroneously considered as characteristic of 
animality. They apparently play a large part in the infection from virus, 
and especially from bacteria and miasms of vegetable origin. They are sup- 
posed to be owing to some obscure chemical action, when under the influence 
of heat, and are of no known importance. 

Butyric Acid. This acid exists in butter, and is evolved when this be- 
comes rancid, occasioning an unpleasant odor. It is rarely found in normal 
urine; more frequently in abnormal. It also appears in diabetic urine upon 
standing for a time, as well as, occasionally, in the urine of pregnant women. 
The cause of its presence in urine is not satisfactorily known, though sup- 
posed to be one of the results of the metamorphosis of leucin. Anhydrous 
butyric acid is a very mobile liquid, colorless, of a powerful odor, and 



CAC 47 CAL 

strongly refracting light. As a hydrate, and united with bases to form salts, 
it is exceedingly repulsive, having the odor of rancid butter. When its salts 
are heated with sulphuric acid, it is set free and emits its peculiar, offensive 
odor; and as it rarely exists in the free state in urine, if at all, the odor 
evolved by this reaction may determine its presence. 



C. 

Cacospermia. Cacospermasia. Defective, or ill-conditioned semen. 

Calculi. Concretions found in various parts of the body, but more com- 
monly in the tonsils, lungs, articulations, bile ducts, prostate gland, and 
urinary bladder; in the latter, a calculus is popularly termed "stone in the 
bladder." They differ in composition and size, and apparently result from 
the deposition and subsequent cohesion of an excess of normal or abnormal 
matters in the fluids of the parts wherein they are found. The substances 
which form a vesical calculus, either alone or in combination, are: uric acid; 
urate of ammonia ; urate of lime ; urate of potassa ; urate of soda ; urate of mag- 
nesia ; xanthic oxide; ammonio-magnesian phosphate ; phosphate of lime; cystine; 
oxalate of Ihne ; carbonate of lime; carbonate of magnesia; silica; oxide of 
iron; benzoate of ammonia; oxalate of ammonia; phosphate of iron; mica; hydro- 
chlorate of ammonia; urea; animal matters. Calculi are divided into organic, 
inorganic, and mixed or alternating. When a calculus is sawn through, and 
the cut surface polished and varnished, it will, in most instances, present a 
surface formed of concentric rings or layers, of different colors, of varying 
degrees of hardness, and of different chemical composition ; and, to deter- 
mine their character, a small portion of each layer, about the size of a pin's 
head, should be subjected to a separate examination. It is rarely the case 
that a calculus consists of only one substance. The nucleus around which 
urinary deposits form to constitute a calculus, are of various kinds ; a very 
common nucleus is oxalate of lime ; uric acid is by no means an infrequent 
nucleus ; the phosphates are very rarely found forming the nucleus of a cal- 
culus. Other nuclei have likewise been encountered, as blood-clot, mucus, 
fibrine, and other foreign bodies forming within the bladder, as well as sub- 
stances that have been introduced into the bladder accidentally, from with- 
out. Sometimes the calculus will have a cavity in its center instead of a 
nucleus. — When a calculus is moist, it should be gradually dried by means of 
a water bath, before proceeding to analyze it. The more common kinds of 
urinary calculi requiring analysis, are those containing uric acid, oxalate of 
lime, and mixed phosphates. 

Constituents of the Various Kinds of Calculi. 

When consisting of — 1. Uric Acid. They are yellowish or reddish-yellow, 
lateritious, especially when moist; yield a wood sawdust-like powder when 
sawn into, and which emits a hydrocyanic odor when slowly heated in an 



CAL 48 CAL 

open vessel, and, when the temperature is elevated to a red heat, it burns 
without residue. It forms unctuous compounds when triturated with caustic 
alkalies ; readily dissolves in diluted alkalies, from which solution it is pre- 
cipitated, by acetic or hydrochloric acid, in crystalline form. It is soluble in 
nitric acid ; the solution, when evaporated and brought into contact with 
ammoniacal vapor, becoming of a rich purple color, which changes to violet 
on the addition of a little caustic potassa. — 2. Urate of Ammonia, in calculi, is 
almost always combined with other substances, and when in the form of layer, 
is of an ash-grey color. It burns without residue, and evolves a strong odor 
of ammonia with alkaline solutions. It is more soluble in water than the 
urates of the fixed alkalies, and, with nitric acid, acts in a manner similar 
to that of uric acid. — 3. Urate of Lime. Is less soluble in water than the 
other urates, and when present is in combination with oxalate of lime, phosphate 
of lime, or the other urates, but in very small quantity. — 4. Urate of Potassa. 
This salt is soluble in about 400 times its weight of cold water, and in much 
less hot water. Its solubility prevents it from being present in a calculus, ex- 
cept in very small amount. — 5. Urate of Soda. This salt is sometimes met 
with in calculi but seldom in any great quantity, though it forms the chief 
constituent in gouty concretions. In many respects it acts similar to the 
urate of potassa. — 6. Urate of Magnesia is much less soluble in water than 
urate of ammonia, and is often met with in urinary calculi. It is generally 
found combined with uric acid, ammonio-magnesian phosphate, urate of am- 
monia, or phosphate of lime ; sometimes it forms an entire layer in a calcu- 
lus, but is seldom found as the only constituent of the calculus. 

7. Xanthic or Uric Oxide, detected by M. Marcet, and others, in calculi ; it 
forms a permanent yellow mass on evaporation from its solution in nitric 
acid, without becoming red by ammonia. It is very seldom met with. Stro- 
meyer found it once in a large calculus, occurring as a white powder, which 
when dried, formed yellowish, hard wax-like masses. — 8. Ammonio-Magnesian 
Phosphate forms a white, crystalline, translucent layer, or calculus, which gives 
a vitreous globule under the blowpipe, by a red heat. When triturated with 
alkalies, the calculus is not dissolved, but emits an ammoniacal odor. This 
phosphate is readily soluble in acetic, hydrochloric, and sulphuric acids. — 
9. Phosphate of Lime is white, opaque, non-crystalline, non-vitrifiable, loses 
hardly anything by calcination, is insoluble in alkalies, but forms a thick 
magma when triturated with them, at the same time evolving heat, but no 
ammoniacal odor. They are less readily soluble in acids than the preceding 
double phosphate. These phosphates (8 and 9) sometimes form the entire 
calculus, at other times they will be found forming an internal or external 
layer of the stone. The calculi containing them are termed Mixed Phosphate 
or Fusible Calculi, because, when acted upon by flame with the blowpipe, they 
fuse and form a hard vitreous globule. — 10. Cystine is very rarely found in 
calculi. It appears to be a feeble organic alkali, of a light-straw color, crys- 
talline, inodorous, soluble in ammonia, but not in water or alcohol. Thrown 
upon burning charcoal it emits a garlicky odor. — 11. Oxalate of Lime. These 



CAL 49 CAL 

calculi are grey, but more frequently deep brown, probably from accompany- 
ing animal matters. They are almost always disposed in undulating layers, 
with surface studded with tubercles, like that of mulberries; calcination de- 
composes them, giving a white slate-colored residue of carbonate of lime, — the 
lime being known by its acrid taste, and the carbonate by its effervescence 
with acids. When this residue consists of lime only, from a prolonged ex- 
posure to heat, it amounts to nearly one-third of the weight of the calculus. 
Oxalate of lime calculi are often met with; on account of their rough, warty 
surface, they are apt to occasion much irritation, with pain, inflammation 
and hemorrhage. — 12. Carbonate of Lime rarely forms calculi by itself; they are 
whitish-grey, presenting an earthy chalk-like appearance, and, in a few cases, 
dark yellow or brown. When present in a calculus it is more apt to be 
mixed with oxalate of lime, earthy phosphates, etc. It is not fusible, but by 
prolonged exposure to a strong heat becomes converted into caustic lime. 

13. Carbonate of Magnesia has rarely been found in human urine, or in cal- 
culi, though more frequently met with in those of animals. 14. Silica^ is still 
more rarely found in calculi, though present in various fluids and solids of the 
body. — 15. Oxide of Iron in calculi is probably due to the presence of uroery- 
thrin, and is found in the ash obtained from a portion of the calculus. — 16. 
Benzoate of Ammonia, Oxalate of Ammonia, etc., have been occasionally detected 
among the constituents of calculus. The Animal .Matters, beside uric acid, 
cystine, and fibrinous matter, probably consist of altered mucus, bladder epi- 
thelia, blood, and urine pigment. 

Analysis of Urinary Calculi. The calculus to be analyzed must first be 
divided into three portions, A, B, and C, each one of which must be acted 
upon separately. From A, is learned in a general way, the nature of the 
stone, organic, inorganic, or mixed, as well as of the bases that may be com- 
bined with the organic substances. B, is designed for the separation of mat- 
ters soluble in acids. C, is to assist in ascertaining the principles soluble in 
water only, without being decomposed. 

Portion A. This portion must be reduced, in an agate mortar, to an ex- 
ceedingly fine powder. A part of it is weighed, placed in a platinum capsule 
and submitted to the action of an elevated heat (by blowpipe or otherwise). 
If the whole becomes dissipated, the calculus consisted of organic substances, 
as, uric acid, urate of ammonia, creatine, etc. If a residuum is left, it must 
be weighed to ascertain the percentage of loss by the heat, after which, its 
character must be determined by a chemical examination. To determine 
whether the organic matter of the calculus is uric acid or a urate, a small 
portion of the original powder (A) may be heated in a watch glass, porcelain 
capsule, or platinum spatula, with a little nitric acid; this solution effected, 
add a few drops of ammonia to neutralize the acid, and then evaporate to 
dryness. The presence of a more or less dark red or purple color indicates 
the Existence of uric acid or of a urate. Any further examination of A 
will be unnecessary. 

Portion B. This portion must also be reduced an exceedingly fine powder. 
4 



CAL 50 CAL 

Place some of this in a platinum capsule (or a glass test tube), add a little 
concentrated hydrochloric acid to it, and boil it, because oxalate of lime, 
should it be present, is soluble only in this acid, boiling. If the specimen 
contained carbonate of lime there will be effervescence from the disengage- 
ment of carbonic acid, and the lime will exist in the solution in the form of 
chloride. If the solution be of a dark-brown color, oxalate of lime may be 
present ; if it be a phosphate, the solution will hardly be discolored. In 
order to determine the substances held in solution in the acid liquor, we must 
verify them by a chemical or microscopical examination. For this purpose 
the solution must be filtered, to remove any organic substances present, and 
then proceed to examine the filtered liquor as follows : — 1. Gradually drop 
ammonia into a portion of the solution, being careful to cease as soon as the 
acid is neutralized, which may be known by a cloudy appearance in the fluid, 
occasioned by the formation of crystals, which will soon be deposited ; or, a 
piece of reddened litmus paper may be placed in the solution, which will be 
restored to its blue color as soon as the liquor becomes slightly alkaline. As 
soon as the precipitate has occurred, we add an excess of acetic acid which 
will dissolve the phosphate of lime and the ammonio-magnesian phosphate, but not 
the oxalate of lime, which, if present, will still remain in the precipitate, 
and may be examined under the microscope. 

2. To detect carbonate of lime, an excess of ammonia must be added to the 
preceding filtered liquor, in order to precipitate all the phosphates present, 
and then filter. To this filtered fluid add a small quantity of a solution of 
oxalate of ammonia. If chloride of lime, derived from the original car- 
bonate, be present, the lime wili unite with the oxalic acid, and be precipi- 
tated in the form of oxalate of lime, which may be verified under the 
microscope ; and the ammonia will combine with the hydrochloric acid, form- 
ing hydrochlorate of ammonia, which remains in solution. If no precipitate 
occurs on the addition of the oxalate of ammonia, it is an evidence that the 
calculus contained no carbonate of lime. 

3. To detect phosphate of lime, take the precipitate left on the filter, in the 
preceding (2) experiment, and dissolve it in acetic acid; then add solution of 
oxalate of ammonia, which, as in the last experiment, precipitates crystals of 
oxalate of lime, leaving phosphoric acid in the solution. Filter the solution 
to remove the oxalate of lime deposited, which may be verified under the 
microscope. 

4. To the filtered liquid remaining from the preceding (3) experiment, 
add a little ammonia, which precipitates the ammonio-magnesian phosphates, 
filter, and examine as named under ammonio magnesian phosphates. See Phos- 
phates. — 5. To find phosphoric acid and thus verify that the lime in the 
calculus existed in the form of a phosphate, a solution of chloride or other 
salt of magnesia, together with some ammonia is to be added to the last 
filtered liquor, when, from double decomposition, the double ammonio-mag- 
nesian phosphate will be formed and precipitated, which may be examined 
as stated in experiment 4. — If it be desired to determine approximatively the 



CAL 51 CAL 

relative proportions of each principle found in the calculus, not only must 
the calculus be weighed, but also its portions, A, B, and C, the filters pre- 
vious to filtering, and the filters with the precipitates collected on them after 
having dried them. Thus, if the calculus weighed 40 grains, and the pre- 
cipitate, from one- third of it, weighs 4 grains (after deducting the weight of 
the filter previously), the whole calculus will have contained about 12 grains 
of said precipitate, and so of each one. 

Portion C. It is hardly useful to examine this portion, unless from the in- 
dications given during the examination of Portion A there is reason to be- 
lieve in the presence of uric acid or urates. By means of an agate mortar, 
reduce Portion C to the finest powder possible; then place it in a large test 
tube, a porcelain, or a sufficiently large platinum, capsule, and add 200 or 
300 times its weight of distilled w T ater. Boil it for 15 or 20 minutes, and 
filter while hot. On cooling, the crystals, which are insoluble in cold water, 
are precipitated, and may be examined under the microscope. See Uric Acid 
and Urates. Urates are decomposed by hydrochloric and concentrated acetic 
acids, etc., and uric acid always loses its original character by the action of 
nitric acid; when once decomposed, their original recomposition becomes 
impossible, — hence the value of water in this experiment, which dissolves 
without decomposing them, and affords much less chance for error than by 
any other means, in determining the true character of the urates contained 
in calculi submitted to analysis, besides allowing a second analysis of each 
substance separately. 

Cystic Oxide, Xanthic or Uric Oxide, and Fibrinous Calculi, are rarely met 
with. They require other processes of analysis, which see under their re- 
spective heads ; also for other principles that have been referred to. 

The following table and explanations will be found useful as a guide in 
the qualitative analysis of urinary calculi. The names in italics must be 
referred to in other parts of the work for further explanations and details. 
The figures and letters refer to those of the same character existing 
in other parts of the table, and, to the article "Observations, etc.," which 
follow it. 



CAL 



52 



CAL 



Table VI. 
Qualitative Analysis of Urinary Calculi. 



Finely pulverize the cal- 
culus, and divide it into 
three portions. 



A, one portion, to determine ( a. Organic, 
the general composition of -j b. Inorganic, 
the calculus. ( c. Mixed. 

B, a second portion, to deter- f 
mine the composition when < 

it is (_ Organic. 

C, a third portion, to de- f 
termine its composition when J 

it is ; j Inorganic, 

L mixed. 



or 



Portion A. 



Put this portion in a cru- 
cible, or on a platinum 
capsule, and heat it to red- 
ness. 



a. There is no residue, or f Organic. See 
only a trace. \ Portion B. 

b. A part disappears, leav- f Inorganic or 
ing a large or very consider- -I mixed. See 
able residue. ( Portion C. 

Remarks. During this operation, observe the following particulars. Odling. 

Carbonization. All urinary calculi, under heat, undergo a slight carboniza- 
tion, and become transformed into a black powder (nitrogenized charcoal), 
due to the organic matters they contain. — In oxalate of lime calculi, it is very 
slight, and the charcoal disappears to give place to an abundant white pul- 
verulent residue. — In phosphatic calculi, the carbonization is more complete, 
and the coal does not burn up so readily. 

Decrepitation. This is always very slight ; when, at the same time, a white 
smoke is given off, and considerable agitation is determined in the heated 
powder, the presence of urate of ammonia may be inferred. 

Odor. Oxalate of lime calculi rarely emit any odor ; the others evolve it 
particularly those of cystine (odor sui generis). 

Volatilization, If the powder becomes almost wholly volatilized, a search 
may at once be made for uric acid, without any farther preamble. See Por- 
tion B. 

Alkalinity. When the heat from an alcohol lamp has been used, any alka- 
linity manifested by the moistened residue upon test paper, is probably 
due to carbonate of soda, proceeding from the decomposition of the urate 
of soda. 

Fusion. The heat from an alcohol lamp, often suffices to fuse mixed earthy 
phosphates. 

Effervescence. To the residue previously moistened, add a drop or two of 
hydrochloric or nitric acid. If effervescence occurs, it indicates the presence 
of a carbonate, either having existed as a salt in the calculus, or resulting 
from the decomposition, by the heat, of a salt with an organic acid, as, oxalate 
of lime, fixed alkaline urates. In the latter case, the effervescence is usually 
feeble. According to Beale, calcined ammonio-magnesian phosphate gives 
effervescence. 



CAL 



53 



CAL 



Portion B. 
N. B. Obs. I, II, etc., refer to the Observations foil 



The calculus is found to be organic ; it may be com- 
posed partly, or wholly, of the following elements : 



1. A sample of the 
powder, B, is treated 

in a capsule by ni- f Heat a sam- 

tric acid; we gently pie of the 

heat it; if efferves- Uric Acid, powder in a 
cence is produced, \ or Urate of -j tube with so- 
and especially if the Ammonia. lutionof caus- 
solution diluted with tic potassa or 

distilled water, gives [_ soda. I. Obs. 

the murexide reac- 
tion. See Uric Acid. 

2. The result of the treatment by nitric acid is a 
lemon-yellow residue ; it does not become red when 
sprinkled with ammonia, but passes to orange-red 
upon the addition of a solution of caustic potassa 
or soda. 

3. The preceding reactions have not been obtain- 
ed ; the calculus contains neither uric acid, urate of 
ammonia, nor xanthine. A new sample of it is 
treated by ammonia, then filtered, and a drop of the 
filtered liquid is allowed to evaporate spontaneously 
on a glass slide. If, under the microscope, hexagonal 
tables and other analogous crystalline forms, are ob- 
served 

4. The heated calculus evolves a strong odor of 
burnt horn, the same as all albuminoid matters; a 
sample of it is to be dissolved in caustic potassa, then 
precipitated from its solution by acetic acid. The 
precipitate redissolved by an excess of the acid, is 
precipitated anew by ferro-cyanide of potassium. 
Mehu. 

5 The calculus has fused without decomposing, 
swells up and evolves a very strong odor, recalling 
that of a mixture of shell-lac and benzoin. Treated 
by nitric acid and heated, a feeble disengagment of gas 
occurs ; the residue, evaporated to dryness and treated 
with ammonia or potassa, becomes dark yellow. 



owing these Tables. 

Uric Acid. 
Urate of Ammonia. 
Cystine. 

Xanthine. Fibrin. 
Urostealith, and pro- 
tein compounds. 



{No Am- r 
monia is I 
disengaged. (_ 

{Ammonia ( 
is disenga- \ 
ged. I 



Uric 
Acid. 

Urate 
of Am- 
monia. 



\_ Xanthine. II. Obs. 



Cystine. 

r 



l Fibrin. III. Obs. 

r 



Urostealith. IV. Obs. 



Portion C. 



A sample of Portion C is 
treated in a capsule by nitric 
acid with heat, the solution 
is then diluted with distilled 
water, and the whole gently 
evaporated to dryness over a 
water bath. — Carefully add 
to it a little ammonia. 




The calculus 
contains uric 
acid, or urates. 

The calculus 
does not contain 
uric acid, or 
urates. 



See b, be- 
low, and 1, 
Portion B. 

See c, be- 
low, and 2 
and 3, Por- 
[ tion B. 



CAL 



54 



CAL 



b. Detection of Uric Acid and Urates. 



f Filtered liquor. See 7. 



-J Urate of Ammonia. 



The Portion C being reduced to an im- 
palpable powder, is boiled for 20 minutes 
with 300 times its weight of distilled water. 
Agitate from time to time. Filter the boil- 
ing liquor, being careful, however, to leave 
in the capsule the earthy deposit that has 
not been dissolved. 

6. If a deposit remains on the filter, ex- 
amine it chemically and microscopically to 
ascertain whether it consists of uric acid. 

7. Place a drop of the filtered solution 
(Obs. V) upon a glass slide, or a piece of 
platinum foil, and allow it to evaporate; 
if there remains no residue, pass to c, be- 
low. In the contrary case, take another 
part of the filtered solution, and boil it in 
a test tube with solution of caustic potassa 
or soda, at the tenth. If we recognize the 
ammoniacal odor, the alkaline reaction of 
moist reddened litmus paper held at the 
orifice of the tube, and the formation of 
white vapors of hydrochlorate of ammonia, 
when a glass rod moistened with hydrochlo- 
ric acid is held over the orifice, 

8. Evaporate another part of the filtered 
solution to a very small amount, add a few 
drops of nitric acid to it, and gently evap- 
orate to complete dryness. If there is a 
rose-colored residuum, becoming purple on 
the addition of ammonia, 

9. Heat this last residuum to redness so 
as to reduce it to ashes, which divide into 2 
equal parts x and y. 

x. This part is to be treated by acetic acid 
and filtered. Add a drop or two of ammo- 
nia to the filtered liquid to neutralize it; 
then add a drop of solution of hydrochlo- -j Urate of Lime. 
rate of ammonia, and treat by an equal 
volume of a solution of oxalate of ammonia. 
If a white precipitate is formed (Obs. VI), 

Filter the preceding fluid, or if there is 
no precipitate treat it as it is by ammoniacal 
-phosphate of soda, and a large excess of am- 
monia; if there is formed a precipitate of 
ammonia-magnesian phosphate in stellate 
or feathery crystals, or resembling fern 
leaves (under the microscope). (Obs. VII), 

y. Treat the other portion by hydrochlo- 
ric acid, diluted with a very little distilled 
Avater, and allow a drop, placed on a glass 
slide, to evaporate spontaneously ; examine 
the residue under the microscope, and if 
cubic crystals of chloride of sodium are ob- 
served, 



Deposit on the filter. See 6. 



I Deposit not dissolved. See c, 
[ below. 

See Uric Acid. 



Uric Acid. 



Urate of Magnesia. 



Urate of Soda. 



CAL 



55 



CAL 



c Detection of Oxalates, Carbonates, and Phosphates. 

The earthy deposit left in the capsule or vessel (b) is treated by concen- 
trated hydrochloric acid; it is then boiled, observing whether the solution is 
effected with effervescence, which indicates the presence of a carbonate, if it 
is complete, etc. The solution obtained, dilute it with distilled water, filter, 
and divide it into two portions, e and/. 

Oxalate of lime. 
Phosphate of 

lime. 
There is ^T"." 5 ™ 1 ;" 1 iae 1 Ammonia -mag- 
a precipi-^ blowing salts: „ e ^„ ph ^ 

phale. 
Carbonate of lime 



Portion e. 



Detection 



of the 



Oxalate. 



Add an excess 
ammonia to it. 



of 



Portion /. 
Detection 

of 
Carbonate 

and 
Phosphates. 



Then add an excess 
of acetic acid to it. 



ist. Add an excess 
of ammonia to it ; fil- 
ter; the filtered liquor 
contains the carbon- 
ate of lime in the state ■ 
of chloride of lime. 
Add to this liquor, 
oxalate of ammonia, 
drop by drop. 

2d. To the precipi- 
tate on the filter, add 
an excess of acetic 
acid; if oxalate exists, 
it remains, (counter 
proof the phosphates 
are dissolved; the li- 
quor obtained is neu- 
tralized by a drop or 
two of ammonia Obs. 
IX , then add hydro- 
chlorate of ammonia 
and oxalate of ammo- 
nia. 

3d. Filter, or if there 
is no precipitate treat 
the liquor as it is by 
an excess of ammonia, 
which will precipi- 
tate the last phos- 
phate held in the li- 
quor, if any exists. 

4th. Acidulate the 
filtered liquor with 
nitric acid, and then 
treat it with an equal 
volume of molybdate 
of ammonia. 



There is 
no precipi- 
tate. 



The whole 
is redissol- 
ved. 



The whole 
is not re- 
dissolved. 
(Obs.VIII.) 



This precipitate j 
contains one of the ■{ 
following salts : 



' 



Remains in solu- - 

tion. 
The calculus 

formed of... 

There is no oxa- 
late of lime in 
the calculus. 

The dissolved pre- 
cipitate indicates 
the presence of 



Oxalate of lime. 



changed 
chloride. 



Carbonate 
lime. 



of 



Phospate of 
lime. 

Ammonio-mag- 
nesian phos- 
phate. 

Separate the 
precipitate and 
ascertain its mi- 
croscopic and 
chemical 
acters. 



char- 



No precipi- -I. No carbonate 
tate. (_ the calculus. 



precipi- 
tate. 



No precipi- 
tate. 



precipi- 
tate. 



Remains in 
solution. 



The precip- 
itate will be 

composed 
of stellated 

feathery- 
like or fern- 
like crys- 
tals. (X 3<»)- I 



A yellow 
precipitate. 



{"; 



s formed of ox- 
alate of lime, and 
indicates 



The calculus con- 
tains no phos- 
phate of lime. 
There remains 
in the liquor 



Carbonate 
Urn e. 



of 



Ammnnio-mag- 
nesian phos- 
phates. See 3d. 



Oxalate of lime is 
formed, indicat- 
ing ~] Phosphate of 

lime. 

Indicates f Amm.mag.phos. 

See 3d. 
Phosphoric acid. 
See 4th. 



Indicates J Ammonio-mag- 

nesian phos- 



Indicates (the re- 
sult of decompo- 
sition of the 
phosphate of 
lime;. 



phale. 



Phosphoric acid. 
(Obs. X.; 



CAL 56 CAL 

Observations Regarding the Preceding Table. 

I. — This should be boiled for some time, holding the test tube with a wooden 
forceps, or engaged in a copper ring. The ammoniacal odor may be per- 
ceived, or else a strip of moistened red litmus paper may be held near the 
orifice of the tube, but without touching it, and which will, more or less rap- 
idly, become blue; on drying it, it resumes its redness. 

II. — Calculi of xanthine have been very rarely observed; they are clear 
brown, and quite hard; by friction they acquire a shining, waxy appearance, 
and are generally formed of amorphous, concentric layers, easy to separate. 
John Davy states that the urinary concretions of spiders and scorpions are 
almost wholly formed of xanthine. 

Ill and IV. — Fibrin and urostealith are very rarely met with. In the re- 
cent state, calculi of urostealith are soft and elastic, and feel like caoutchouc; 
on drying they shrink up and become brittle. 

V. — Upon allowing a drop of the solution, placed on a glass slide, to evap- 
orate spontaneously under a bell glass, the microscope will sometimes reveal 
some of the known forms of the urates. 

VI. — The white precipitate is formed of oxalate of lime, but in the form of 
small grains agglomerated in little groups ; this is due to the rapid precipi- 
tation which does not allow the time required for the formation of the regu- 
lar crystals. In neutralizing with ammonia, too much is sometimes added, 
and the liquid becomes turbid ; the addition of a few drops of acetic acid 
will dissolve this slight precipitate and clear up the fluid. 

VII. — Like the preceding, this precipitate is very slow to form when there 
are only traces of magnesia. After having well agitated it, a few drops may 
be placed in a clear sample tube, closed with a cork, and be allowed to rest 
for 24 hours. If, at the end of this time, a small crystalline deposit occurs, 
this will show, under the microscope, the regular forms of ammonio- / magnesian 
phosphate, and the existence of traces of magnesia may be asserted. — These 
crystals must not be confounded with groups of rosaceous crystals which 
sometimes appear, when distilled water, rendered ammoniacal, is treated, by 
phosphate of soda. (Phosphate of Soda and Ammonia. Microcosmic Salt.) 

VIII. — This precipitate of oxalate of lime, suddenly obtained, does not 
present the regular octohedral form, but shows itself under the form of a col- 
lection of very black square or roundish points, sometimes with small prisms 
cut basiled, and uniting in horse-shoe or X form. This black powder is very 
characteristic, and its chemical characters should be verified. 

IX. — Same observation as at VI, for the neutralization with ammonia. 
When we do not ulteriorly search for soda, we may neutralize with carbonate 
of soda. — A few drops of hydrochlorate of ammonia is added, because mag- 
nesia is not precipitated by oxalate of ammonia in presence of the salts of 
ammonia. 

X. — Examined some time after its formation, this precipitate is observed 
in the form of yellow spherules, with black outlines, agglomerated by plates. 

Calculous Oxide. See Cystic Oxide. 



CAN 



57 



CAE 



Cancerous Fragments 
in Urine. Matter from 
cancerous ulceration of any 
part of the urinary tract 
generally exists in the urine 
in the form of more or less 
blood corpuscles and coag- 
ula, and numerous cancer 
cells, giving to the urinary 
deposit a thick, dirty, blood- 
stained appearance. No 
pus corpuscles, or but very 
few, are present. The cells 
are in small masses, and of 
various shapes, nucleated, 
caudate, oval, spindle- 
shaped, or irregular ; the 
nuclei often being large; 
the cells may also enclose 
secondary ones. This is 
almost always from cancer- 
ous disease of the bladder, 
which is ordinarily of the 
villous kind; and in frag- 
ments of it, under the micro- 



Fig. 12. 




der invariably contains this variety. 



A. Five free cancer nuclei. 

B. Small cancer cell. 

c. Large cancer cell. 

d. A cell with two nuclei. 

e. e, e. Compound or mother cancer cells, containing 
two, three, or more nuclei. 

/. A mother cell, containing a simple nucleus, and a 
nucleated cell. 
g. Irregular and bifurcated cancer cells, the most 

scope, the capillary vessels usual forms. 

forming the villus may be h ' Cells containing double nuclei; cancer of the blad- 

seen, the epithelial coloring 
being either present or absent. Great care must be taken not to confound 
these cells of cancerous growth with epithelial cells of the urinary passages, 
there being considerable resemblance between them. In the diagnosis, not a 
few cells, but the entire character of the deposit must be taken into consider- 
ation, together with the concomitant symptoms, as pain in the bladder, more or 
less profuse hemorrhages from this viscus, difficult micturition, complexion, 
constitutional symptoms, etc. — Should the malignant affection be located in 
the kidney, no dependence can be placed upon these deposits in the urine. — 
In melanotic cancer, the action of oxygen upon the urine, or the addition of 
nitric or chromic acid to it, when freshly passed, will turn it black; though 
all black urine does not always indicate malignancy. Cancer cells, blood 
corpuscles, renal tube casts, etc., may be examined almost as perfectly as they 
exist in their natural fluids, by placing them in a solution of 20 grains of 
white sugar in 4 fluidrachms of distilled water, to which 2 or 3 drops of pure 
crystallized carbolic acid is added; or, still better, a solution of pure glycerin 
27 minims in 4 fluidrachms of distilled water. 

Carbolic Acid. Phenic Acid. This acid is rarely, if at all, found in 



CAE 58 CAE 

human urine, except after the internal or endermic administration of tar, 
carbolic acid, etc., when the urine assumes an olive-green, a dark, or blackish 
color, and may also emit the characteristic odor of the acid. This odor may 
be observed upon evaporating the urine at a low temperature. It should, 
however, be remarked that pure phenic acid has been administered internally 
without any appreciable effect upon the urine, and it has been suggested 
whether the acid giving rise to the changes in the urine might not be mixed 
with cresylic acid. Again, free carbolic acid dissolved in alcohol, forms with 
ammonia a phenate of ammonia, or an artificial aniline; and, very probably, 
the blue and other dark tints of the urine may be developed by the forma- 
tion of this ammoniacal phenate in it. Staedeler supposes carbolic acid to 
be one of the odorous principles of urine. To determine carbolic acid from 
creosote, A. M. Eead states, that a solution of creosote in glycerin becomes 
cloudy when water is added, and the creosote separates; while a solution of 
carbolic acid in glycerin presents no such effect upon the addition of water. 
Among the tests for detecting the presence of carbolic acid, may be named 
the following: — 1. Put a little chlorate of potassa in a test tube, and cover it 
with hydrochloric acid; after a reaction of about 1 minute, dilute the mix- 
ture with 1J volumes of distilled water. The gas which forms upon the 
surface must be removed by careful blowing, and then ammonia is gently 
poured on so as to float upon the surface of the acid liquid. Again blow, to 
remove the vapors of chloride of ammonium, that are generated, and then 
allow a few drops of the suspected urine to flow down along the side of the 
tube. If carbolic acid is present, the upper colorless layer of liquid will 
assume a color varying from the darkest brown through all shades of red- 
brown, blood-red, rose-red, according to the amount of carbolic acid present. 
One part in 12,000 may be detected. C Rice. — 2. Bromine water added to the 
liquid tested, if carbolic acid be present, gives an immediate bulky precipi- 
tate of tribromophenol. This will detect 1 part of carbolic acid in 43,700 
parts of fluid. Landolt. — 3. A solution of nitrate of protoxide of mercury, 
containing very minute traces of nitrous acid, when boiled with a solution con- 
taining carbolic acid, gives a reduction of the mercurial salt, and, sooner or 
later, according to its dilution, the liquid assumes an intense red color. One 
part in 200,000 may be detected. P. C. Plugge. — 4. Agitate the suspected 
urine with ether, decant the layer of ether, and allow it to evaporate on a 
watch glass ; an oily residue is obtained. A part of this dissolved in a little 
distilled water, and then placed in contact with perchloride of iron assumes 
a purplish color, and, with ammonia and alkaline hypochlorites, a blue tint. 
That which remains upon the watch glass, submitted to the action of fuming 
nitric acid, forms picric acid, which dyes silk yellow. Patrouillard. 

Carbonate of Ammonia. Ammonium Carbonate. See Alkaline Urine. 

Carbonate of Iiime. Calcic, or Calcium Carbonate. When human urine 
is alkaline from the presence of carbonate of ammonia, it sometimes contains 
a small portion of carbonate of lime, which is precipitated with the earthy 
phosphates in an amorphous condition, insoluble in water. It is always 



CAR 59 CAR 

present in small quantity, in the form of black or yellowish grains, present- 
ing concentric and radiating strice like the transverse section of the trunk of 
a tree. The grains, however, are often so small that these strise can not be 
seen. Occasionally it is seen in small globular spheres, discs, and cornucopia- 
like crystals. In the urine of the horse it is more often observed, giving a 
jumentous aspect to it, and the spherules of its aggregated acicular crystals 
are larger than in the human liquid. It rarely forms a sediment, a urinary 
calculus, or a portion of one ; these calculi are very hard and smooth exter- 
nally, of a grey, yellow, or bronze color, and rarely larger than a hazlenut. 
Upon the addition of acetic or hydrochloric acid, to the well-washed sedi- 
ment, the lime is dissolved, and carbonic acid gas is evolved ; and when all 
the acid gas has been driven off, the addition of oxalate of ammonia to the 
solution gives a precipitate of oxalate of lime. The crystals may be known 
by their strongly refracting light, by disengaging carbonic acid gas in contact 
with acids, and by polarizing light. A dark amorphous sediment of urates 
may be determined by the addition of an acid, which is sooner or later fol- 
lowed by the formation of uric acid crystals ; this never occurs when car- 
bonates are thus acted on. 

Carbonate of Magnesia. Magnesic or Magnesium Carbonate. The form- 
ula varies according to the relative proportions of the precipitants, the 
temperature of the solutions, and of the desiccation. This salt is probably 
sometimes contained in the urine, as it has been observed in urinary calculi. 
It is stated to be more common in the urine of herbivorous animals. When 
present in the urine, it may be detected by evaporating this fluid, calcining 
the residue, and then dissolving it in water. The portion which remains 
undissolved, is separated by filtration, and dissolved in dilute hydrochloric 
acid. If it be a carbonate, an evolution of carbonic acid gas will occur. It 
may be lime or magnesia. Neutralize a portion of the solution with am- 
monia, then add a few drops of solution of phosphate of soda, when, if mag- 
nesia be present, crystals of ammonio-magnesian phosphate will be formed, 
and may be recognized under the microscope. — To detect carbonate of mag- 
nesia in a calculus, dissolve a portion of this in a little dilute hydrochloric 
acid, and then add ammonia to form hydrochlorate of ammonia. Treat the 
liquid by solution of phosphate of soda, and from double decomposition the 
same result occurs as stated in the preceding instance. 

Carbonate of Silver. Argentic, or Silver Carbonate. Test for Uric Acid. 
To the suspected urine add a few drops of nitrate of silver solution, to pre- 
cipitate the chlorides and phosphates, which interfere with the reaction; 
quickly filter to remove these, and then add solution of carbonate of soda. 
A precipitate of carbonate of silver ensues, of a grey colar, if uric acid be 
present. Tannic acid gives a similar reaction, but it can be determined from 
uric acid by the ink-black color occasioned by the addition of chloride of 
iron. — The above test may be made by dissolving a little uric acid in car- 
bonate of soda, put a drop or two on paper, and add a drop of nitrate of 



CAR 60 CAR 

silver, which will give the characteristic grey stain. — This will detect the 
?7 |o^th gramme of uric acid. 

Carbonate of Soda. Sodic, or Sodium Carbonate. It has been estimated 
that from 4.86 to 11.66 grammes of soda pass in the urine during every 24 
hours, the amount varying according to the quantity of soda salts ingested 
with the food. Carbonate of soda is not generally considered a healthy con- 
stituent of urine, being due principally to the kind of food that has been 
eaten, as fruits containing malates, lactates, acetates, citrates, and tartrates, 
which during their passage through the organism, become converted into 
carbonates ; a part of the carbonate of soda may escape by urine, when the 
ingestion of a large quantity of these fruits has occasioned an abundance of 
this salt in the blood. It is found in alkaline, but not ammoniacal, urine. 
Carbonate of soda may exist in urine and not be detected in the ash, the car- 
bonic acid having been removed by the heat, or by decomposition ; on the 
other hand, the decomposition of lactates and oxalates by incineration may 
give rise to carbonate of soda when none existed in the urine. In the analysis 
of urine for carbonate of soda, it will always be proper to precipitate all the 
phosphates; then the presence of the soda carbonate in the urine, or in its ash, 
may be ascertained by the means named under Carbonic Acid, Carbonates, and 
Potassa. However, from the combination of this alkali (soda) with other 
organic acids, etc., it may prove quite difficult to determine the precise 
quantity of carbonate of soda present in the urine. 

Carbonates. In addition to the carbonates above referred to, that of 
potassa has also been met with in urine. Traces of carbonate of potassa 
have been observed in urinary calculi, especially in those formed of uric acid, 
pure or united with ammoniacal or other urates. The presence of these salts 
appears to be due to the ingestion of vegetable aliments which contain salts 
of these alkalies [potassa and soda] with vegetable acids, as, potatoes, herba- 
ceous plants, fleshy fruit, cherries, strawberries, apples, grapes, etc., which, 
during their passage through the organism, become converted into carbonates. 
The presence of carbonic acid in the urine is readily known by the addition 
of dilute acetic or hydrochloric acid to the urine, which occasions efferves- 
cence. If the carbonate of lime be previously separated from the urine, and 
then effervescence ensues on the addition of an acid, carbonate of soda (or 
potassa) is probably present. Another method is to evaporate the urine, 
calcine the residue, apply the acid to the remaining ash, and if effervescence 
occurs, a carbonate is present. To determine whether it is lime, magnesia, 
potash, or soda, see the Urates of these bases, also the table under Calculi. 

Carbonic Acid in Urine. This acid is present in solution in fresh urine. 
To detect it pass some pure hydrogen through the urine, and then conduct 
into it pure lime or baryta water, whrch, if a minute quantity of acid be 
present, will occasion a turbidity of the urine, or, if the carbonic acid be in 
considerable amount, there will be a precipitate of carbonate of lime or 
baryta. If the insoluble carbonate of baryta, thus precipitated, be collected 
on a filter, washed, dissolved in hydrochloric acid, and precipitated by sul- 



CAR 61 CEL 

phuric acid, on weighing the precipitate of sulphate of baryta thus obtained, 
the amount of carbonic acid in the urine may be calculated therefrom. 

Carmine. This substance is employed in solution for the purpose of 
staining or coloring cells, epithelia, casts, etc. It colors epithelia and non- 
granular leucocytes a rose, the color being especially fixed upon the nuclei. 
Non organized bodies, as well as vegetable elements — spores, bacteria, etc., 
are not colored by it. If, after having colored certain elements, a drop 01 
two of acetic acid (1 of acid to 10 of water) be added to the preparation, 
the color becomes fixed exclusively upon the nuclei and is more brilliant. 
Various preparations of carmine, are employed, and among them the following : 
— 1. Ammoniacdl Solution of Carmine. Dissolve a few grains of pure carmine 
in a little ammonia, and then dilute with distilled water. Filter into a flask, 
and any undissolved portion of carmine remaining on the filter maybe preserved 
for other uses. Place the flask, uncorked, under a bell glass, allowing it to 
remain thus for 12 or 18 hours, that the ammonia may be evaporated ; or a 
quicker method of removing this alkali, is to neutralize the solution with a 
few drops of acetic acid until it has only a very slight ammoniacal odor. In 
either case, a small amount of carmine may be precipitated, which, when the 
solution is nearly exhausted by use, may be redissolved with a few drops of 
ammonia, and prepared as above. See Picro-carminate of Ammonia. — 2. 
BeaWs Solution of Carmine. Place carmine 10 grains in a test tube, and add 
ammonia 30 minims. Agitate and heat over a spirit lamp until the carmine 
is dissolved. Boil for a few seconds, and allow it to stand an hour or 
two ; then add pure glycerin, 2 ounces, distilled water 4 ounces. Should the 
carmine at any time become deposited, add a few drops of ammonia. See 
Double Staining. 

(amine. See Hyjpoxanihin. 

Carnivorous Animals. The urine of these animals is clear, transpar- 
ent, of an acid reaction, containing uric acid, alkaline and earthy phosphates, 
and urea. Prolonged abstinence causes the uric acid or the urates to disap- 
pear, urea alone persisting. 

Carrots, used freely as an article of diet may give rise to oxalate of lime 
in the urine. 

Caseine. An organic albuminous substance, coagulable by acids, but not 
by heat, supposed to have been detected in chylous and kiesteinic urine, but 
the existence of which has only been satisfactorily demonstrated in milk. 

Casts of Bright's Disease. See Renal Casts. 

Cauliflower. When eaten, this vegetable gives a very unpleasant odor 
to the urine, and also a few crystals of oxalate of lime. 

Cell, or Utricle, that peculiar formation upon which, either in an isolated 
or aggregated condition, the existence of animals or vegetables depends — ■ 
"the ultimate organized unity of animal life." The cell is an imperforate 
vesicle or membranous sac, enclosing a liquid cell-sap, and having a thin 
delicate, albuminous wall. The vegetable cell has, in addition, an external 
or thick, strong, cellulose wall or layer. When cells develop other cells, 



CEL 62 CHL 

they are termed parent or mother cells, and the newly formed cells, daughter 
cells. Cells are also termed corpuscles, and very minute cells are frequently 
called cellules. 

Cellular, Having reference to, or constituted of, cells. 

Cera nutria. A name applied to urine giving deposits of earthy, and 
earthy alkaline, phosphates. 

Chalk. This substance may be placed in urine accidentally or designedly ; 
its tests are those named for carbonate of lime ; examined under the micro- 
scope some of the microscopic organisms entering into the formation of chalk 
may be detected, as, foraminiferous shells, etc. 

Chemieal Reaction of Urine. This has reference to the acid, neutral, 
or alkaline condition of the urine, and is generally determined by reddened 
litmus paper for the alkaline, and blue for the acid. Neutral urine has no 
effect upon either of these test papers. See Acidity of Urine; Alkalinity of 
Urine. 

Chemical Reagents. The various chemical reagents used in the investi- 
gation of urine, referred to in this work, will be found respectively under the 
heads of the articles themselves : thus, for " Compound Solution of Iodine " 
refer to Iodine; for "Ammoniacal Tincture of Carmine," refer to Carmine; 
for " Solution of Acetate of Lead," refer to Lead, etc. — In using chemical 
reagents and test fluids, the practitioner should be careful to have them accu- 
rate, and to know with exactness the strength of every test fluid. His gradu- 
ated vessels, pipettes, etc., should be correctly marked, and every vessel, 
pipette, etc., should be kept clean when not in use; these necessary atten- 
tions will enable him to obtain positive and satisfactory results, which can 
not be had by an opposite course. 

Chloral. Liquor Potassa added to fluids containing chloral, renders them 
turbid, and evolves a chloroformic odor. See Urochloralic Acid. 

Chlorate of Potassa. Potassic or Potassium Chlorate. This salt is detected 
in the urine, and in the saliva, by means of sulphate of indigo, a solution of 
which is decolorized by a liquid containing 5 ^ th of chlorate of potassa. 
Dissolve indigo in sulphuric acid, and add this solution, drop by drop, to a 
small amount of the urine to be examined. The solution is decolorized as 
long as any non-decomposed chlorate of potassa remains, but as soon as the 
chlorate is completely destroyed, the urine assumes the blue color of the 
indigo solution. By always operating upon the same volume of urine, its 
richness in chlorate may be comparatively judged of, by the number of drops 
required. — The tincture of litmus, in presence of sulphuric acid, is equally 
decolorized by chlorate of potassa; but it is less sensitive, not acting upon a 
fluid containing 73th of chlorate. — Chlorate of Potassa promptly and mark- 
edly reduces the quantity of urea, and is useful in boils when an excess of 
urea is present in the urine. 

Chloride of Ammoninm. See Hydrochlorate of Ammonia. 

Chloride of Sodium. Sodic, or Sodium Chloride. Common salt is ordi- 
narily present in healthy urine mixed with traces of chloride of potassium. 



CHL 



63 



CHL 



Being very soluble, it is never found in urinary deposits. Its presence is due to 
the fact that nearly all food and water contain more or less of it. It not only 
proceeds from the food, but, likewise, from the destructive assimilation of the 
tissues, nearly all of which contain some of it. Suppress the food, and the 
salt will rapidly diminish in the urine, and fall to a regular discharge of two 
or three grammes daily. When diminished in amount, or wholly absent, 
the health of the person deteriorates. Urine containing salt, in health, aver- 
ages sp. gr. 1,015; and from 100 to 300 grains of salt passes per twenty-four 
hours, according to the quantity ingested. The normal quantity passed is, 
according to Robin, and Beale, 3 to 8 parts in 1.000 of urine ; to Vogel, 10 to 
13 grammes per day, or, 6 to 8 grammes of chlorine. The urine of persons 
dying is almost wholly deprived of salt. In testing the urine for salt, this 
fluid should be perfectly clear and transparent, or be rendered so by decanta- 
tion or filtration. Should albumen be present, it must be coagulated by heat 
or nitric acid, and then removed by filtration. For exact estimation the 
method referred to under quantitative analysis may be pursued; but for the 
detection or approximate estimation of the salt, Nitrate of Silver Solution No. 
1 will be sufficient. 

X Detection. 



1. 

Acidulate 10 c. c. 
of the urine with 2 
or 3 drops of Nitnc 
Acid. 



Now add the solu- 
tion of Nitrate of Sil- 
ver. No. 1, drop by 
drop, until it no long- 
er produces any tur- 
biditv. 



A white curdy preci- 
pitate shows the pre- 
sence of chlorine (in the 
form of chloride of sil- 
ver), insoluble in acids ; 
soluble in ammonia. 



Remarks. — 1. The acidulation with nitric acid is to prevent the precipita- 
tion of phosphates, phosphate of silver being very soluble in acids. Care 
must be had not to add an excess of nitric acid, as it will precipitate uric 
acid. It is generally the better plan to boil the urine and filter it, previous 
to acidulating it with nitric acid. — 2. The argentic solution must be added 
until a precipitate is no longer produced, which is very readily ascertained 
by observing that a drop of the solution fails to occasion any farther turbid- 
ity of the urine ; then the precipation of the chlorine is complete. — 3. The 
precipitate should be entirely soluble in ammonia. If an insoluble portion 
remains, an excess of the argentic solution has been added, and phosphate of 
silver has been precipitated ; a little nitric acid added will dissolve this 
phosphate. 

Quantitative Analysis. 

+ Approximative. If the preceding process for detection is conducted in a 
graduated test tube, by allowing the precipitate to rest for twelve or twenty- 
four hours, its height in the tube may be read off. By repeating this daily, 



CHL 64 CHL 

with fresh samples of urine, the variations in quantity of the salt may be 
ascertained for each day. Thus, if 10 c. c. of urine give a precipitate of 2 
grammes per day, and if the whole amount of urine passed during the day 
be 1,050 c. c, we will have in this urine about 210 grammes of chloride of 
sodium. By recording these amounts, there will be no difficulty in deter- 
minating the approximate quantity of this salt passed daily. It has been 
ascertained that, on an average, 1 c. c. of a tested urine of twenty-four hours' 
standing, corresponds to 62 milligrammes of chloride of sodium. 

Exact. The reagents employed in this more tedious and troublesome 
analysis, are, Nitrate of Silver Solution, No. 2, and Solution of Neutral Chromate 
of Potassa. The estimation of chloride of sodium by nitrate of silver is based 
upon the fact that, in a neutral solution, containing chloride, phosphate, and 
chromate, the salt of silver precipitates the acids of these salts in the follow- 
ing order: 1st, hydrochloric acid; 2d, chromic acid; 3d, phosphoric acid. A 
urine containing chlorides and phosphates, must have a chromate added to 
it, which will give, with the argentic salt, a characteristic reaction, apprising 
the operator that the precipitation of the hydrochloric acid is terminated. 

Preliminary Steps. 

1. We must be certain that the urine is not albuminous ; if this be the 
case, coagulate the albumen by heat, and filter. — 2. On no account must 
there be any free acid in the urine, because of the ready solubility of the 
chromate of silver. — 3. The urine must be neutral to litmus, or slightly alka- 
line. If it be acid, carefully neutralize it by a drop or so of ammonia, con- 
veyed on a glass rod. Avoid adding too much, because the precipitate is 
dissolved in it. If the urine be very alkaline, it can be exactly neutralized 
with acetic acid ; to effect which, a piece of blue litmus paper is placed in 
the urine, and the acid added, drop by drop, on a glass stirring rod, until the 
paper commences to become pale. This neutralization is delicate ; the first 
time one attempts it, he may be obliged to repeat it anew. 

These preliminary steps observed, the operation is very simply effected, as 
follows : — To 5 c. c. of the urine, add a few drops (3 to 5) of the Solution of 
Neutral Chromate of Potassa (see Potassa), and agitate the liquor to thoroughly 
mix the fluids. Then, by means of a pipette graduated into cubic centi- 
metres and tenths, drop into the mixture Nitrate of Silver Solution, No. 2, con- 
stantly stirring, until a persistent reddish tint is produced. The operation is 
now terminated. Every c. c. of the argentic solution that has been used in 
this process, indicates the presence of 1 centigramme of chloride of sodium, 
or 6.06 milligrammes of chlorine. — This is a very beautiful reaction. The 
liquid, which is at first of a light canary -yellow color, exhibits, at those 
points on which the silver solution falls, reddish spots, which disappear, 
when the fluid is stirred, so long as any chloride of sodium remains in it. 
But, as soon as this chloride is wholly decomposed by the silver solution, the 
very next drop that is added, produces a permanent reddish color of chromate 
of silver, which is soluble in nitric acid. 



CHL 65 CHL 

Corrections. — This method, thus simplified, gives too high a figure for the 
chloride of sodium, because there are always other substances beside chlorine 
that have been precipitated by the silver solution. Hardy.— Our investiga- 
tions made on titrated solutions of chloride of sodium, and estimated by this 
method, then upon urine previously tested and treated with known weights of 
sea salt, have led us to allow as constant, an error of an excess of 1 gramme 
per litre. There is an advantage in operating upon only 5 c. c. of urine; the 
estimation is more exact, because the change of color is manifested more 
rapidly. "When the quantity of chloride of sodium in 5 c. c of urine is 
ascertained, the entire quantity for 1 litre can be calculated, from which sub- 
tract 1 gramme. — It should, also, be remarked, that the red color will not 
appear at first; if the silver solution be carefully added, drop by drop, con- 
stantly stirring the fluid, the tints of coffee and milk, chocolate, brown-red, 
and brick-red, will be observed to appear in succession. If the operation be 
stopped at the brown-red coloring, too high a figure will be obtained, having 
dropped in the urine nearly a cubic centimetre too much. The milk and 
coffee tint is that at which the operation should be terminated, when it does 
not pass unperceived; but with a little attention it will not be permitted to 
escape observation. In fact, it announces that a trace of chromate of silver 
is produced, which, spread throughout the whole mass of the fluid, gives this 
particular tint very different from the initial color. — The tubes must be 
cleansed with ammoniacal water. (Marais.) 

Other Methods. — 1. This is based upon the fact that chlorine gives a soluble, 
and urea an insoluble, compound with peroxide of mercury, while that of 
chlorine has a greater affinity for mercury than urea has; therefore, if perni- 
trate of mercury be added to a solution containing chlorine and urea, the 
chlorine will first combine with the mercury, and no precipitate of the com- 
pound of urea and mercury will take place until all the chlorine has been 
saturated; and if we observe how much of the mercurial solution has been 
used before a precipitate commences to form, we can at once ascertain the 
quantity of chloride present. It is necessary, in this operation, to first 
remove the phosphates from the urine, which is effected by means of the 
Baryta Solution. The reagent is the standard Solution of Pernitrate of Mercury. 
The process is as follows: To 40 c. c. of urine add 20 e. c. of Baryta Solu- 
tion ; when the phosphates have all become precipitated, filter through a 
filtering paper rendered feebly acid by diluted nitric acid, and then allowed 
to dry. Place 15 c c. of the filtrate into a beaker glass, and carefully add a 
drop or two of nitric acid to just produce a faintly acid reaction. Now, keep- 
ing the urine constantly in motion by means of a glass rod, allow the perni- 
trate of mercury solution to fall into it, from a graduated burette, drop by 
drop, until a slight persistent turbidity (precipitate) ensues. Then from the 
scale of the burette read off the quantity of the mercurial solution required 
to effect this precipitate, every 1 c. c. of which corresponds to 10 milli- 
grammes of chloride of sodium. By calculation, it is easy to determine the 
whole amount of this salt in the urine of 24 hours. — Enough of the baryta 
5 



CHL 



66 



CHL 



Fig. 13. 



solution must always be added to the urine, to precipitate the whole of the 
phosphates. — 2. For greater accuracy, 10 c. c. of the urine are placed in a 
platinum crucible, to which 1 or 2 grammes of pure nitrate of potassa, free 
from chlorine, are added. After the potassic salt is dissolved, the whole is 
gradually evaporated to dryness, and then exposed to a low red heat, until 
the carbon is completely oxidized, and the contents of the crucible are white. 
After cooling, these are to be dissolved in distilled water, a drop or so of 
nitric acid added to the solution to faintly acidulate it, a small quantity of 
carbonate of lime solution being then introduced to again restore neutrality 
to the acidulated solution; and then the chloride may be estimated by one 
of the preceding processes. — As by far the greater part of the chlorine in the 
urine is in combination with sodium, the above processes may answer to 
determine the amount of chlorides present. 

% Microscopic Examination. Crystals of chloride of sodium are cubical, 
similar to those of iodide and bromide of potassium, but assuming several 

varieties. The presence of 
urea modifies their crystal- 
lization from urine; they 
are then found in large crys- 
tals in the form of daggers 
or crosslets, either isolated 
or grouped perpendicularly 
one above the other. When 
in octohedral forms, these 
crystals may be distinguish- 
ed from those of oxalate of 
lime, by their solubility in 
water. The crystals of 
chloride of sodium disap- 
pear under the polarizing 
apparatus at the same pe- 
riod when the field of the 
microscope becomes dark, 
which will aid us in dis- 
tinguishing it from other 
crystals of similar form, 
which give colors, or may 
be seen under the polarizer, 
when the microscopic field 
becomes obscure. This salt 
in the urine may be exam- 
ined by placing a drop of 
fresh clear urine upon a 
glass slide, and then allowing it to evaporate under a bell glass, to one-fourth 




c. 



D. 



Chloride of sodium, in combination with urea, and 

evaporated quickly from urine. 
Chloride of sodium, crystallized from distilled water, 

and resembling oxalate of lime ; never exists in urine, 

and is soluble in water, while the oxalate is not. 
Chloride of sodium crystallized slowly from urine, 

also resembles oxalate of lime, but differs in being 

soluble in water. 
Chloride of sodium resembling crystals of cystine 

from slow evaporation of urine. 



CIIL 67 CHL 

or one-sixth of its volume; to serve as a comparison, a drop of a solution of 
salt may, at the same time, be placed by the side of it. See Fig. 13. 

Clinical Import. The amount of chloride of sodium in the urine, varies 
according to circumstances. The maximum amount is found during the 
day, and the minimum during the night; influenced, however, by diet, and 
mental or physical labor. Chlorides increase in the urine according to the 
amount of chlorine compounds introduced into the organism, whether in 
health or disease. The ingestion of a large quantity of water, and all causes 
which increase or diminish the secretory activity of the kidneys, temporarily 
increase the chlorides. The presence of the crosslets and dagger-like crystals 
of chloride of sodium in a partially or wholly evaporated urine, afford a 
safe indication of the presence of urea. — In acute disease, there is diminu- 
tion and sometimes disappearance of chloride of sodium in the urine; 
the diminution of the chlorides, being in proportion to the intensity of the 
attack, and, to a great extent undoubtedly, to the suspension of food ; and their 
disappearance will announce the production of serous effusions, or of inflam- 
matory exudations. This fact is not special to pneumonia. Beale intimates 
that chloride of sodium accumulates at any point in which inflammatory 
changes are occurring. In intermittent fever, Vogel states that there is an 
increase of the chlorides during the access. — In acute articular rheumatism, 
when the chlorides suddenly disappear from the urine, and albumen can be 
detected in this fluid, pericarditis may rapidly ensue. In cholera, the chlo- 
ride of sodium diminishes greatly, its subsequent increase is a highly favor- 
able indication. — In chronic disease, the results are variable. A diminution 
of the chlorides indicates debility of the digestive power, if there does not 
exist another way of elimination, as, serous diarrhea, or hydropic effusions. 
A considerable increase will indicate diabetes insipidus. — It must be remem- 
bered, however, that these indications are not wholly reliable. — Chloride of 
sodium is the antidote of bromide of potassium, promptly antagonizing its 
action. 

Chlorides. These never form spontaneous deposits in the urine, the 
chlorine being combined with soda, potassa, lime, or magnesia, forming 
salts that are very soluble. The presence of which must be ascertained by 
chemical processes referred to elsewhere. See Chloride of Sodium, ; Chlorate 
of Potassa; Chloride of Ammonium; Chlorine. 

Chlorine. The amount of chlorine discharged in healthy urine per 24 
hours, varies, according to circumstances, from 5 to 8 grammes. An approx- 
imate estimation of its- amount may be made as follows : Prepare a test fluid 
by dissolving pure fused nitrate of silver, 1 grms. 861 (grammes), in distilled 
water 87 c. c Of this solution 30 c c. will correspond to 129 milligrammes 
of chlorine. To perform the operation, take some of the urine, and remove 
albumen, if present, by the addition of a little acetic acid, and boiling. Sepa- 
rate the coagulated albumen by filtration. Acidulate the clear filtered urine 
with nitric acid, and carefully measure into a beaker 7.4 c. c. of this acidu- 
lated urine. The silver solution being placed in a burette or pipette gradu- 



CHL 68 CHO 

ated into tenths of a cubic centimetre, is allowed to fall, drop by drop, 
into the urine, which must be constantly stirred, as long as a white precipi- 
tate occurs. The moment the silver test solution ceases to occasion a precip- 
itate, the process is terminated. The amount of test solution used may now 
be read oft' upon the burette, and as 30 c. c. of it represents 129 milligrammes 
of chlorine, we ascertain by calculation the amount existing in 7.4 c. c. of the 
urine ; and by knowing the whole amount of this fluid discharged per day, 
we can, therefrom, determine the entire amount of chlorine contained in it. 

Chloroform. This agent is sometimes employed to remove fatty matters, 
to dissolve and separate cholepyrrhine from biliverdin when these are pres- 
ent in the urine, and for other purposes in the investigation of urine. Chlo- 
roform may be^found in the urine of persons who have taken it (or chloral) 
internally, as well as of those who have inhaled it for the production of anaes- 
thesia, — by the following process : Pass a current of air bubblingly through 
the urine, so that it becomes charged with the vapor of chloroform disengaged 
from this fluid; the current thus charged, is directed through a porcelain 
tube heated to redness. The chloroform vapor is decomposed, and the result- 
ing chlorine, being passed through a Liebig's carbonic acid apparatus, with 
bulbs, containing a solution of nitrate of silver, of determined strength, 
forms therein a precipitate of chloride of silver. From the weight of this 
body, the quantity of chlorine, and, lastly, that of the chloroform are 
deduced. — According to Baudrimont the cupro-potassic liquids employed to 
detect the presence of .sugar in urine, likewise form precipitates, when this 
fluid contains a little chloroform, chloral, or other substances that may engen- 
der chloroform. M. Limousin relates a case in which an error was made in 
the analysis of the urine of a person recently chloroformized. This urine 
was declared glucosuric, because of the precipitate given when treated by a 
cupro-potassic solution. An error of this character might lead to serious 
consequences. 

Chlorophyll. The green coloring matter of plants, somewhat analogous 
to that of the urine ; it is a substance of a waxy nature, soluble in ether or alco- 
hol, which discharges its green tint; is not affected by water; becomes a 
yellowish-brown by tincture of iodine, and more or less deep blue by sul- 
phuric acid. Preparations containing chlorophyll lose their green color 
when mounted in chloride of calcium. 

Chlorosis. In this affection the solids of the urine are more or less 
diminished, and, sometimes, even when the urine is nearly colorless, an 
abundance of urohematin may be detected by adding one-fourth its volume 
of strong nitric acid to the fluid, and then boiling ; it becomes red, if urohe- 
matin be present. 

Cholalic Acid is a product resulting from the decomposition of both 
cholic and cholinic acids. It has a bitterish sweet taste like gall, is insoluble 
in water, soluble in 27 parts of ether, and readily soluble in boiling alcohol, 
and in alkalies. It crystallizes from alcohol in octohedra and tetraheda, be- 
longing to the quadratic system, and which are of a vitreous brilliancy. 



CHO 69 CHO 

Cholepyrrhin. See Bile Pigments. 

Cholesterin. This is a peculiar fatty substance forming a normal element 
of brain and nerve tissue ; it is also met with in the bile, the blood, and other 
animal fluids. Occasionally it has been detected in the urine, combined with 
other fats, proceeding from renal fatty degeneration. When it exists in the 
urine, the sediment must be collected and dried over a water bath, and then 
digested in a mixture of alcohol and ether. Filter this solution ; concen- 
trate it by evaporation, and upon cooling crystals of cholesterin will form in 
more or less profusion. These are of variable size, rhomboidal or rectangu- 
lar, extremely thin, frequently showing a break on one of the borders, and 
ordinarily imbricated one over the other. Many of the crystals have their 
obtuse angles truncated. They are readily determined under the microscope, 
with a power of 300 or 400 diameters. If the crystals are colored, they 
should be redissolved in boiling alcohol, filtered through animal charcoal, 
and upon the cooling of the liquid, they will form in colorless plates. 
Boiled a long time with nitric acid, a resinous mass is formed, which, by 
prolonging the boiling, becomes converted into cholesteric acid, C 8 H 4 4 under 
the formation of acetic, butyric, and capronic acids, etc. Cholesterin is 
a neutral body, white, pearly, insipid, inodorous, insoluble in water, slightly 
so in cold alcohol, very soluble in boiling alcohol, and does not saponify with 
alkaline liquors. It is heavier than water. Sulphuric acid in contact with 
dry cholesterin, on a white porcelain plate, gives a beautiful play of colors, as, 
different shades of orange, red, purple, and green. When pus has stood for 
several days, crystals of cholesterin may be detected in it. See Fats. 

Choletelin. — A substance, existing in the urine of persons laboring under 
hepatic disease, being derived from bile pigment by oxidation. 

Cholic Acid. Glycocholic Acid. Various bodies have been described under 
this name. Cholic or Glycocholic Acid crystallizes in extremely fine nee- 
dles, which are at first voluminous, but shrink together on drying. It is a 
bile acid, scarcely soluble in cold water or ether, more soluble in boiling 
water and alcohol. It has a sweet taste, a feebly acid reaction, and, at an 
elevated temperature, melts, and is decomposed, evolving a peculiar odor. 
Caustic alkalis, and alkaline earths, decompose it. Solution of sugar mixed 
with its solution, and concentrated sulphuric acid then added to it, a purple- 
violet color occurs at a heat of 122° to 158° F. Its salts have a neutral reac- 
tion. Boiled with a strong solution of hydrate of baryta it is decomposed, 
and yields cholalic acid and glycocoU. 

Cholinic Acid. Taurocholic Acid. Bemains in solution, after the deposi- 
tion of cholic acid from bile, under the action of dilute sulphuria acid. It 
has a bitter-sweetish taste, an acid reaction, and under the action of caustic 
alkalies is decomposed, yielding cholalic acid, and Taurine, differing, in this 
respect, from cholic acid. 

Cholochlorine. See Bile Pigments. 

Choloidic Acid. Choloidinic Acid. This acid is obtained by the decom- 
position of cholic acid when boiled with dilute hydrochloric or sulphuric 



CHO 70 CHY 

acid. It is solid, amorphous, white, inodorous, insoluble in water, scarcely 
soluble in ether, and very soluble in alcohol. It forms salts with bases, 
which, with the exception of the alkaline, are insoluble. When boiled for a 
long time in dilute hydrochloric or sulphuric acid, it becomes changed into 
glycocoll and dyslisine, C 24 H 36 3 . 

Cholopheine. See Bile Pigments. 

Ctiromaturia. Discharge of abnormally colored urine. 

Chrosnog-en. A peculiar colorless substance met with in indigoferous 
plants, which, under the action of acids and ferments, yields indigo blue, a 
peculiar kind of sugar, and a small amount of other matters. The term has 
also been applied to indican found in urine. 

Chylo-serous Urine. See Chylous Urine. 

Chylous Urine. Urine having a milky, turbid, and opaque appearance, 
due to the presence of fatty matter in a molecular form (but rarely any oil 
globules), fibrinous particles enclosing red-blood corpuscles, perhaps, also, 
albumen or albuminoid substances. When much blood is present a rose tint 
is imparted to the color. Upon standing for some time, a tremulous coagu- 
lum occurs, succeeded by flakes, the fatty matter floating, like cream, upon 
the surface of the liquid. Sometimes the urine coagulates within the blad- 
der and is voided with difficulty and more or less pain. Heat, and nitric 
acid, coagulate chylous urine. If the urine be mixed with ether, the fatty 
matter is dissolved, and the urine assumes its natural color and transparency. 
If the ether be evaporated, it yields a yellowish uncrystallizable fat, solid or 
fluid. Under the microscope, the fatty particles in chylous urine require, to 
be seen distinctly, the highest powers, at least a power of 450 diameters. The 
appearance of chylous urine is very irregular, sometimes coming on gradu- 
ally, at other times breaking out suddenly. It may last a short or long time, 
then disappear, and return again after a certain interval. Its cause is un- 
known, though several hypotheses have been advanced. Rest, vegetable diet, 
and fasting lessen the milky character of the urine, while meats appear to 
increase it ; it also varies in amount during the day, the urine being more 
natural in the morning, and chylous after meals, etc. The urine is neutral, 
or faintly acid, soon becoming alkaline. The presence of chylous urine is 
not necessarily an unfavorable indication, nor does it denote disease of the 
kidneys unless accompanied with coagulated fibrin, renal casts. The disease 
is more common in tropical climates, and is apt to be attended with pains in 
the loins and epigastrium, lassitude, emaciation, etc.; occasionally no un- 
pleasant symptoms, nor impairment of health are present ; and again it has 
been observed during the presence of certain maladies, as, epilepsy, erysip- 
elas, diabetes, tuberculosis, etc. No satisfactory method of treatment is 
knoAvn. When death occurs in instances of chylous urine, it is generally the 
result of some accompanying, but independent, malady. 

Cliyluria. A discharge of chylous urine, without any apparent indica- 
tions of renal disease. 




CIN 71 COL 

Cinnamic Acid. This acid, formerly mistaken for benzoic acid, is a 
constituent of Tolu, Peru, and some other balsams, of storax, sweet gum, 
Botany bay resin, etc. When taken internally it becomes transformed into 
hippuric acid, which is then found in the urine. 

Coddington Lens. Fig. 14. A simple microscope, consisting of a glass 
sphere, around the center of which a triangular groove is cut ™ , . 
and then tilled with some opaque matter. When properly 
constructed, it possesses a large field of view, with slight aber- 
ration, and a good magnifying power, and is so arranged that 
it may be safely carried in the vest pocket for bed-side examin- 
ations. It is superior, for this purpose, to the Stanhope lens. 
However, as there are excellent pocket compound microscopes 
manufactured at the present time, for clinical and other ex- 
aminations, to be made away from the physician's office, and 
which are furnished at moderate prices, it will be much better CoddmgtonLens. 
to procure one of these, when it can be done, as, from their magnifying 
powers, they are adapted for nearly all urinary investigations. 

Cod-liver Oil. Taken internally, lessens the free acidity of the urine, 
and likewise diminishes the amount of urea and uric acid. Beneke. 

Coffee. Taken internally, lessens urea and uric acid ; also the amount of 
chlorine in the urine. The pulmonary carbonic acid is increased by it. 
Cafiein has the same influence in a minor degree. According to Dr. Ham- 
mond, coffee is more of a stimulus to the brain faculties than tea. 

Colcliieum. The internal use of this agent, lessens the quantity of urea 
and uric acid in the urine, and sometimes diminishes the amount of water, 
as well as of the earthy phosphates. It increases the solids in the urine. 

Colica Nephritis. Nephritic Colic. Intense pains in the renal region 
and along the course of the ureters, due to acute inflammation of the kidneys, 
or to the descent of a calculus along the ureter into the bladder. 

Collection of Urine. In ordinary investigations the first urine of the 
morning will be sufficient, especially for the mere determination of the pres- 
ence or absence of certain normal or abnormal elements. But where as 
much accuracy as possible is required, the whole amount of urine passed 
every 24 hours should be collected and kept by itself, examining it as soon 
as possible after its discharge, and, likewise, several hours afterwards. Cer- 
tain kinds of urine speedily decompose, while others do not change for a long 
time, and may be properly examined in 24 or 48 hours after being voided. 
It does not make so much difference as to the vessel in which the urine is 
contained, so that it is clean, and will admit of being covered to prevent the 
entrance of extraneous substances. A half gallon magnesia jar, or similar 
bottle, will answer the purpose very well; and this may be graduated by a 
diamond writing point, or by means of fluoric acid, into fluid ounces or cubic 
centimetres, so that the practitioner can at once read oft' the amount at a 
glance. Glass jars are made especially for this purpose, holding 2,000 c. c, 



COL 



72 



COL 



Fig. 15. 




Graduated Glass Jar. 



graduated into 5, 10, or 50 c. c. The greatest difficulty in collecting all the 
urine of every 24 hours will be found with children, 
and with patients prostrated from severe illness, or 
who are paralyzed, or delirious. For women and 
children, special forms of apparatus are employed 
(urinals) ; for the others, watchfulness is required, 
and, after as near a determination as possible of 
the amount of urine not collected or lost, 20 per 
cent, may be allowed for any error in the estimate. 
Yet, in these cases, it can not be expected that the 
same certain or satisfactory conclusions can be ar- 
rived at, as in those instances in which the entire 
amount of the urine of 24 hours is collected, — though 
useful and important information may always be ob- 
tained. — In public institutions for the sick, and not 
unf requently in private practice, it becomes necessary 
or desirable to examine each specimen of urine passed 
at different times during the night and day. Sev- 
eral small vessels may be kept for this purpose. All 
vessels should be carefully and thoroughly cleansed 
immediately after their contents have been removed, 
or when they have been satisfactorily investigated. 

When the urine has stood the required time, it should be decanted from 
its sediment, and this be then placed in a smaller vessel for subsequent ex- 
amination ; or the sediment may be collected on a filter. For small amounts 
of urine with deposits, 4 fluid ounce conical glasses with lip and foot, will be 
found useful ; the bottom of these vessels, inside, instead of terminating in a 
small convexity should end in a point. The height and diameter of these 
glasses should be large enough to allow the use of an urinometer, when it is 
desired to ascertain the sp. gr. of the urine. See Preliminary Remarks, page 13. 
Color of Crino. Healthy urine is of an amber color, due to certain 
coloring substances present in it. When disease is present, this fluid will 
present various tints according to the malady and the existing circumstances. 
The urine may be pale, greenish, straw-yellow, brown, red, or dark. These 
tints may be due to an excess or diminution of the normal coloring matters, 
to an increase or decrease of the quantity of water, to the presence of blood, 
coloring matters of bile, and other abnormal coloring agents, and, lastly, to 
certain articles of diet or medicine which impart coloration to the urine. 

According to Harley, who has 'carefully investigated the coloring matters 
of the urine, the normal coloring agent is a substance derived from the blood, 
and held in solution by the urine, its quantity fluctuating according to the 
state of the health, and to the circumstances influencing the organism. And 
as he has been able to detect a common character in the composition of this 
agent, bUiverdin, chlorophyll, draconin, hemxtin, indigo, and melanin, viz., the 
presence of iron, he concludes that, with a few exceptions, the various colors 



COL 73 COL 

that have been observed in urine, yellow, red, green, blue, brown, and black, 
are derived from a common source, a white radical (proceeding from the 
blood), of which they are simply different grades of oxidation, and may, 
therefore, be considered under one head. Even the green biliverdin of the 
bile may result from oxidation of the red hematin of the blood. He has named 
the normal coloring matter of the urine, urohematin; and, according to its 
degree of oxidation, the quantity present in the urine, and the action of 
certain substances contained in, or added to, the urine, are its various tints 
developed. Thus, in one urine, nitric, hydrochloric, and sulphuric acids, 
may occasion the same color, while in another urine, each one of these acids 
may color the urine a tint differing from that caused by the others. He states 
that the quantity of urohematin passed every 24 hours, may be considered 
" a tolerably exact measure of the destruction of blood corpuscles," being " an 
index to the tear and wear of the tissues," and " the best measure we at pres- 
ent possess of the rapidity with which burns life's lamp." As the rule, 
the darker the urine, the more serious the condition of the patient. 

Vogel, and many other authors, Scherer, Pplli, Virchow, etc., consider the 
urinary pigments (and biliary) as products of the decomposition of hematin, 
basing their views upon the following reasons: — The coloring matter of 
the blood is destroyed with difficulty ; the blood extravasated in the teguments 
(ecchymoses) like that which is left to various influences external to the 
body, tenaciously holds its color, with more or less modification. Hence, it 
is not probable that the hematin, which has been used and rendered unfit for 
the purposes of the organism, is eliminated from the body as a colorless sub- 
stance. Moreover, the only colored excretions of the body are the urine 
and the feces, and, consequently, the urinary pigment, or the bile pigment (as 
modified in the feces), or even both of them, may be considered as products 
of decomposition of hematin. From this, it follows that, the quantity ex- 
creted of these pigments, may give the measure of the intensity of the 
destruction of the blood globules. Thus, in all acute febrile diseases, the 
quantity of the coloring matter of the urine is greatly increased. This 
increase is still greater in septic fevers. Now, a diminution of the blood 
globules and an anemic condition are the consequences of all these diseases. 
On the contrary, in those cases where the formation of the blood globules is 
less active, as, in chlorosis, anemia, neuroses, etc., the quantity of urinary 
pigment is much below the normal standard, the urine being very pale. — By 
establishing a scale of colors, Vogel has proposed a process of proximative 
estimation of the urinary pigments. 

In health, the urine fluctuates between a pale straw and a brownish- 
yellow tint, the depth of color being due to the amount of water holding the 
coloring matter in solution ; thus, after large draughts of water, or beer, the 
urine becomes very pale and abundant ; during periods of profuse perspira- 
tion, this fluid is darker and in diminished quantity; in lessened perspiration, 
as, during winter, the urine is nearer its average normal color, and in in- 
creased amount, etc. However, a urine, pale, or of a normal color, is not 



COL 74 COM 

invariably an indication of health, as, it may contain an abnormal quantity 
of urohematin, or, of one or more of its derivatives, determined only by 
proper investigation. High or dark-colored urine almost invariably indi- 
cates the existence of a more or less grave pathological condition of the 
system. 

The exceptions to the preceding statements, are the accidental colorations of 
the urine after the ingestion of certain vegetable and other matters, as, aloes, 
arseniureted hydrogen, blackberries, cactus opuntia, campeachy wood, carbolic 
acid, creosote, gallic acid, gamboge, indigo, logwood, madder, picrotoxin, rasp- 
berries, resin, rhubarb, santonin, senna, tar, turpentine, etc. 

A dark-colored urine, when diluted with water, will, according to the 
amount of dilution, give all the colors more commonly observed in this fluid, 
thus strengthening the hypothesis that these various tints are only dilutions 
of one and the same character of coloring agent. From this, Vogel has fur- 
nished, as a standard for the approximative determination of the amount of 
urohematin existing in a given urine, a table of nine different shades of color. 
See VogeVs Table of Colors. 

Coloring- Matters. The coloring agents of the urine, may be considered 
as normal, abnormal, and accidental. The normal, are urohematin and uro- 
xanthin; the abnormal, are not so readily named, as some of them have been 
found in healthy urine, being changed conditions of the two normal colors, — 
however, they may at present be considered as follows : Bile acids, bile pig- 
ments, blood corpuscles, hematin, hemoglobin, melanin, methozmoglobin, pus, uroery- 
thrin. See Urobiline. 

Composition of Urine. Urine is a complex and variable liquid, being 
influenced, as regards its composition, by health, diet, exposure, mental or 
physical labor, etc. It consists, on an average, of 21.11 parts of water and 1 
part of solids. The solids are in solution when the urine is voided, but may 
be deposited on standing, or by the use of chemical agents. The various 
organic or nitrogenized principles held in solution, are, the debris of the or- 
ganic changes, as, urea, uric acid, 'creatin, creatinine, ammonia, hippuric acid, 
xanthine, hypoxanthine, sarcine, normal pigment, mucus, unoxidized sulphur and 
phosphorus, etc., — the eleven, last mentioned, together with minute quantities 
of oxalic and lactic acids, being frequently classed under the head of ex- 
tractive matters; also, chlorides, phosphates, alkaline and terreous sulphates, proceed- 
ing either from the interchanges of the materials of the organism, or derived 
from the external world with the food and drink. These materials circula- 
ting in the blood, — the remains of the nutritive processes, either extraneous 
to it, or useful in part, must be expelled through the renal filter. The urine 
also contains carbonic acid gas and nitrogen. 

The above refers to the composition of healthy urine ; a morbid condition of 
this fluid varies considerably in its composition, — there may be an absence, a 
diminution, or an excess of one or more of its physiological elements, or, some 
new and unnatural principle may be mixed with the urine, as, albumen, sugar, 
fat, cystine, blood, pus, fibrine, epithelial cells, sperm at ozoids, biliary matters, etc. 



CON 75 COP 

Confervoid Growths in Trine. See Algae; Fungi. 

Consistence of Trine. Urine in health is perfectly fluid, like water, 
readily flowing through, and dropping from, a tube of exceedingly small cali- 
bre. Disease may render it thick, viscid, and so tenacious that it will not 
drop from a tube or vessel, but will form ropy, stringy masses on attempting 
to drop or pour it; this is the case with urine, alkaline from ammoniacal 
decomposition, and containing pus. Chylous urine is often of such in- 
creased consistency as to form a thick, firm, jelly-like mass. I have met 
with several cases in which the urine was passed of a white color and of the 
consistence of cream, forming a thick jelly-like mass shortly after being 
voided ; it contained no fat of any kind, but an incredible amount of mucus 
and phosphates. 

Copaiba. Or rather its copaivic acid, when taken internally, is eliminated 
by the urine in large amount, imparting a peculiar odor, sui generis, to this 
fluid. Nitric acid added to such urine occasions a copious precipitate of an 
oily or gelatinous character, and which has been mistaken for albumen. 
However, it consists chiefly of copaivic acid, separated from its combination 
with soda or potash by the nitric acid, and which is deposited together with 
urates or uric acid. The urine, containing copaivic acid, is very apt to have 
its color heightened, its quantity increased, its quality altered, its appear- 
ance somewhat turbid, and its taste bitter. 

Copper. Cuprum. This metal, when it or one of its salts, is taken in- 
ternally, passes off in the urine, as well as in the feces, and may be detected 
in cases of poisoning by it. It maybe detected as follows: 1. Place the 
urine in a vessel upon a water bath, and treat it with chlorate of potassa and 
fuming hydrochloric acid, until both the chlorate and the organic matters 
are wholly destroyed. To the pale straw-colored liquid thus obtained, add 
an excess of ammonia to render it alkaline, which imparts a smoky-brown 
hue to it. Filter to remove any precipitate. Evaporate, on the water bath, 
until the filtrate is perfectly dry, and the residue that remains is then to be 
moistened with pure nitric acid (sp. gr. 1.5), placed in a china capsule, and 
heated to redness, until no charcoal remains. Dissolve the ashes in hydro- 
chloric acid, and boil, adding a little nitric acid, to keep up the highest pos- 
sible oxidation of the iron and Copper present. Add an excess of ammonia 
to this acid solution, and remove the resulting precipitate of hydrated oxide 
of iron by filtration. If, upon adding acetic acid to the filtrate, it becomes 
bluish, or if it furnishes a reddish turbidity, or reddish- brown deposit with 
ferrocyanide of potassium, copper is present. A clean piece of iron, as a 
knife blade, will, when held in the solution, acidulated, become covered with 
a deposit of metallic copper. Sulphureted hydrogen, or sulphide of am- 
monia, will occasion a brown or black precipitate of sulphide of copper, pro- 
vided the alkaline liquid is acidulated with hydrochloric acid. 

Copper is likewise employed in the investigation of urine for the detection 
of sugar, being one of the reduction tests for this purpose. Grape sugar, in 
presence of a solution containing copper, precipitates this in the form of a 



COP 76 COP 

brick-red suboxide; but it should be likewise remembered that the presence 
of glycerin, cellulose, uric acid, chloroform, and leucine, produce in different 
degrees, a reduction of the oxide of copper, while albumen, interferes with 
the reaction. The several copper tests that have been proposed are based 
upon the same principle (viz., the property that grape sugar has, in the pres- 
ence of free alkali, and at an elevated temperature, of depriving oxide of cop- 
per of one-half its oxygen, and thus converting it into a red suboxide), and are 
only modifications of each other; it is unnecessary to name all of them, only 
those more commonly employed. Among these the best are : — 1. Fehling's 
Solution, a. Take of pure, air-dried sulphate of copper 34.64 grammes, dis- 
tilled water 200 grammes ; mix. b. Take of neutral tartrate of potassa 173 
grammes, solution of caustic soda, sp. gr. 1.12, 600 grammes; mix. — Add the 
copper solution, a, to the alkaline liquid, b, in small quantities at a time, and 
when this is done, add enough distilled water to make the whole measure 
exactly 1 litre. It requires exactly 10 c. c. of this clear, violet-blue liquid 
to be reduced by 0.05 gramme (or 50 milligrammes) of sugar. This solution 
maybe used for both the qualitative and quantitative examinations; it is 
subject to precipitation when kept any length of time, hence it is better to put 
it into smaller bottles holding 60 or 80 grammes, seal them, and keep in a 
dark place in the cellar. Label " Fehling's Cupro-potassic Solution." Detection 
of Sugar. % E. Boivin and D. Loiseau, have observed that when 1 c. c. of 
this test liquid is added to 50 c. c. of distilled water, and boiled for a few 
minutes, it becomes wholly decolorized, which result may be prevented by 
the presence of a small amount of a calcareous salt ; this is important to bear 
in mind, when using Fehling's or Pavy's solution for minute quantities of 
glucose. In consequence of the changes effected in this test-liquid, which 
give rise to error, the following modification has been advised, which, it is 
stated, will keep perfectly, may be boiled for a long time with or without 
pure cane sugar, and may be exposed to diffused daylight, without depositing 
any suboxide of copper : 1 gramme neutral tartrate of copper, 40 grammes 
pure hydrate of sodium, and 50 grammes distilled water. The neutral tar- 
trate of copper is procured by treating a solution of sulphate of copper, with 
neutral tartrate of potassium^ washing the precipitate with pure distilled 
water by decantation, and then carefully drying it at 212° F. — W. L. Classen, 
states that the determination of glucose by the cupro-potassic tartrate, is a 
much more certain and reliable method than by the saccharimeter. E. Pol- 
laci states that the urine should always be treated by a solution of acetate of 
lead, to precipitate its coloring matters and any tannin that may be present, 
as these substances interfere with the exactness of the result with the cupro- 
potassic test of Fehling (and others), by exerting a reducing action upon this 
test the same as the sugar itself. — E. Baudrimont states that chloroform in 
the urine gives a precipitate of chloral, etc., which may lead to an error in 
supposing sugar present when this is not the case. — 2. See Pavifs Test or Solu- 
tion. — 3. Harley employs two solutions; one, a solution of potassa, sp. gr. 
1.060 ; and the other, a solution of ten grains of pure sulphate of copper to 



COR 77 CRE 

the fluid ounce of distilled water. — Cupi^ic, or Copper Sulphate, are recent 
terms for sulphate of copper. See Ammonio-oxide of Copper. 

Corpora Amylacoa. Microscopic roundish bodies with concentric layers, 
giving the peculiar violet color with iodine and sulphuric acid, have been 
found in the urine ; their indications are not known. 

Cotton. Very careless observers, and occasionally very careful ones, and 
especially in hospitals where it is often almost impossible to prevent, will find 
fibres of cotton in the urine, which may be mistaken for renal casts. Patients 
who are careless in collecting their urine, may likewise have these fibres in 
this liquid. Under the microscope these fibres have a fiat limp appearance, 
with a dark medullary part, often looking like narrow glassy cylinders, vary- 
ing in diameter from so^th to y^othof an inch. They are not dissolved by 
potassa, are dissolved by ammoniccd solution of copper, and give the blue color of 
iodide of cellulose with iodine and sulphuric acid ; first carefully applying 
the acid (which causes them to swell), and then the iodine water. Nitric 
acid does not cause cotton to swell. 

Creatine. This substance exists in the blood and in the fleshy tissues in 
small amount, and has been detected in the urine to the quantity of from 
194. to 420. milligrammes per 24 hours. It may be considered an excretion, 
holding an intermediate position in the retrogressive tissue-metamorphoses 
between the most complex protein bodies and the simpler forms, urea, etc., 
being more closely allied with the latter. In the grave forms of uremia, in- 
stead of finding ammonia or urea in the blood, creatine, creatinine, and other 
extractives are present, and which may in a later stage of histolysis be con- 
verted into urea and uric acid. At present this substance is of no practical 
value in affording any clinical indications. — Creatine may be obtained, by 
neutralizing 200 or 300 c. c. of fresh urine with a little lime water, and then 
adding solution of chloride of calcium to precipitate all the phosphoric acid. 
Filter, and concentrate quickly in a water bath so as to eliminate the greater 
part of the inorganic salts by crystallization ; separate the liquid from these 
salts, and add to it ^th its weight of a concentrated syrupy solution of 
chloride of zinc, free from acid, and set it aside for several days. Crystals 
of creatine are formed, also creatinine mixed with chloride of zinc. Filter 
the liquid to separate the crystals and wash them with warm water ; then 
dissolve them in boiling water, and treat with freshly precipitated and 
well washed hydrated oxide of lead, until the reaction is alkaline. The 
oxide of zinc, and insoluble basic chloride of lead are removed by filtration, 
the filtrate decolorized by animal charcoal, and then evaporated to dryness. 
The residue is then treated with boiling alcohol, which dissolves the creatin- 
ine, and leaves the creatine which may be recrystallized from its solution in 
boiling water. 

Simple evaporation of urine on a water bath may give these crystals in 
plates or prisms according to the degree of evaporation ; they are pearly or 
micaceous, transparent, brilliant, and splendidly color polarized light, which 
will distinguish them from salt crystals. 



CRE 78 CUE 

Creatine crystallizes in transparent, glistening, rectangular prisms belong- 
ing to the clinorhombic system, and which are usually connected with each 
other in tufts or groups. They have a pungent taste, are inodorous, perma- 
nent in the air, soluble in 74.4 parts of cold water, very soluble in boiling 
water, dissolve in 9,410 parts of alcohol, and not at all in ether. At 212° F., 
they lose their water of crystallization, and at a higher temperature are de- 
composed. They have no reaction on colored reagents, do not form salts with 
acids, and dissolve in baryta water without change, crystallizing again from 
the solution. Boiled for a long time in baryta water they are converted into 
urea, and sarcosine; boiled in concentrated acids, they are converted into 
creatinine, parting with 2 atoms of water. 

Creatinine. Although having the same composition as creatine, less 4 
equivalents of water, its properties are very dissimilar. It is found in the 
muscles in small quantities, and in a greater amount in urine, from 5 to 10 
grains per 24 hours, and is the product of the natural or artificial decompo- 
sition of creatine. Like creatine and urea, it may be considered as an excre- 
mentitious substance, and is of no practical value in a clinical point of view, 
as far as known. To obtain it, take the alcoholic solution from which the 
creatine was directly procured, by filtration, and carefully evaporate it, — crys- 
tals of creatinine are formed. The evaporation should not be too slow, for 
under long exposure to heat, and in dilute solution, creatinine, by taking up 
4 equivalents of water, becomes reconverted into creatine. Should the urine 
employed in the preceding process for obtaining these two extractives, con- 
tain albumen, this must first be coagulated, and then separated by filtration. 
Creatinine crystallizes in the form of colorless, brilliant, right rectangular 
prisms of the clinorhombic system. They have a pungent, ammoniacal 
taste, a strong alkaline reaction, form crystallizable salts with acids, and are 
soluble, in 11 parts of water at 68° F., in much less boiling water, in 100 
parts of cold alcohol, and in a very small quantity of ether. Boiling alcohol 
dissolves the greater part of them, most of which become recrystallized as 
the solution cools. If urine containing creatine be allowed to stand exposed 
to the air for 2 or 3 weeks, the creatine will be converted into creatinine. 
Aqueous solution of creatinine gives reddish crystals with bichloride of 
platinum, and a white flocculent precipitate with corrosive sublimate. E. 
Maly gives a process for procuring large, brilliant, and hard crystals of 
hydrochlorate of creatinine by precipitation with bichloride of mercury, 
which it is not necessary to repeat. 

Creosote. Creosote, as well as phenic acid, is stated to occasion a black 
deposit in the urine; and, although there is a close alliance between the creo- 
sotic compounds and indigo, the matter is but imperfectly understood. Min- 
eral creosote gives a blue color with a weak and very slightly ammoniacal 
chloride of iron, while vegetable creosote gives a green color succeeded by 
a brown. In observing these cases of coloration in the urine, from this 
agent, it is important to know the character of the creosote employed, the 



CKI 79 CYS 

presence or absence of cresylic acid, and, likewise, of phenic acid. See Car- 
bolic Acid. 

Crimnodcs Crina. Urine depositing a sediment resembling bran. 

Cryptophanic Acid. This acid, detected in urine by Thudicum, was 
considered by him to be the cause of the acid reaction of this fluid. The 
process for obtaining it is, to add milk of lime to the urine until it is alka- 
line, filter, acidify with acetic acid, and evaporate to a syrupy consistence. 
Allow a crystalline deposit to form, and when terminated, decant, and mix 
the clear liquor with strong alcohol ; after the resulting precipitation has 
ceased, purify the dark, impure cryptophanate of lime by repeated solutions 
in water, filtration, and reprecipitations with strong alcohol. Finally, add 
acetate of lead to a solution of the salt, then add alcohol to precipitate the 
cryptophanate of lead from the liquid, and decompose this salt by the addi- 
tion of an equivalent amount of sulphuric acid. The acid forms a trans- 
parent amorphous, gummy, and nearly colorless mass, readily soluble in 
water, less so in alcohol, and decomposes the carbonates with effervescence. 
Aqueous solutions of its earthy salts yield an abundant white precipitate 
with nitrate of mercury. Thudicum believes that this last reaction shows a 
fault, or liability to error, in the determination of urea by Liebig's method, 
probably, to the amount of 5 or 10 per cent, in excess, and which renders a 
correction of this process (allowing for cryptophanic acid) necessary. It is 
a tetrabasic acid. — Pircher in applying the method of fractional precipi- 
tations to cryptophanic acid, is disposed to view it as only a mixture of 
principles. 

C'nbebs. When taken internally, imparts its odor to the urine, and is 
stated to occasion precipitates in this fluid, resembling albumen. 

Cnminic Acid. Is voided by the urine unchanged. So are cumarinic 
acid C 9 H 8 3 , camphoric acid C 10 H 16 4 , and anisic acid C 18 H s 3 . 

Cyanate of Ammonia. Amnionic, or Ammonium Cyanate. When urea 
is decomposed by an elevated heat among the products of this decomposition 
are cyanate and carbonate of ammonia. If a solution of the hydrated cya- 
nate of ammonia be evaporated to dryness, both the cyanic acid and ammonia 
become lost, and urea remains. By digesting this in alcohol, and evaporat- 
ing the filtered solution, pure urea is obtained. 

Cyanourine. Urocyanine. This is a term applied by Braconnot to a blue 
or violet coloring matter observed in urine. — An indigo-color now termed 
uroglaucin, though at one time applied to uroglaucin and urrhodine in com- 
bination. 

Cylinders. See Renal Tube Casts. 

Cystic Oxide. See Cystine. 

Cystine. Cystic Oxide. Vesical Oxide. This is an abnormal ingredient of 
urine, but rarely found. It may occur as a sediment, and occasionally it 
forms small calculi, of which it is the chief ingredient. Urine containing it 
is generally paler than healthy urine, frequently of an oily appearance, with 
occasionally a greenish tint, and usually of low sp. gr. It is generally neu- 



CYS 



80 



CYS 



tral, rarely acid, bat soon becomes alkaline. Urea and uric acid are apt to 
be deficient ; and the odor of the urine is similar to that of sweetbriar, but 
on decomposing, it exhales sulphureted hydrogen, and some ammonia. The 
sediments more commonly observed in urine containing cystine are, ammonio- 
magnesian phosphates, mucus, epithelia, and sometimes oxalate of lime ; but 
it may be present when these are absent. Cystine is not ordinarily observed 
among old persons, — generally, during middle age and any period previous 
thereto ; and, it has been stated, that its presence in the urine may be found 
in certain families, the disposition to its formation passing from one genera- 
tion to another. 

When cystine is held in solution in a neutral or alkaline urine, a deposit 
may not occur, until acetic acid has been added, which precipitates it either 
in an amorphous form, or in imperfectly formed six-sided crystals. When 
occurring spontaneously in acid urine the crystals are in hexagonal plates, 
occasionally in quadrangular, and sometimes in multangular plates or 
rosettes, with sharply crenate margins, darker in the center than at the cir- 
cumference. The crystalline plates are thin, and often lie one over the 
other, and, probably, the rosettes are formed in this manner. (See Fig. 16.) 

Cystine forms white, or pale 



Fig. 16. 




A. Cystine, as an urinary deposit. 

B. Cystine, crystallized from an ammoniacal solution. 

C. Vibriones, found in urine of debilitated persons. 

D. Scaly epithelium from the vagina. 



fawn-colored, amorphous 
deposits; its crystals pre- 
sent a pale-yellow, or 
amber color, opaque in 
bulk, transparent in thin 
plates, and free from taste, 
odor, or reaction. Exposed 
to light and air it changes 
its color, becoming of a sea- 
green hue. It is soluble in 
ammonia, the caustic alka- 
lies and their carbonates, 
and in nitric, hydrochloric, 
sulphuric, oxalic, or phos- 
phoric acids; insoluble in 
acetic, citric, or tartaric 
acids, water, alcohol, and 
in carbonate of ammonia. 
It forms salts with the min- 
eral acids. Carbonate of 
ammonia precipitates it 
from its acid solutions, and 



acetic acid from its alkaline. Its solution in ammonia evaporated sponta- 
neously, gives rise to magnificent crystals, which, like the others, color polar- 
ized light. The crystals may be determined from those of uric acid by their 



CYS 81 CYS 

solubility in ammonia, and from those of chloride of sodium by their insolu- 
bility in water, and in not disappearing when the urine is heated. 

Cystine more commonly exists in form of calculi having a white or yellow- 
ish, crystalline, wax-like substance, tasteless, neutral, and gritty between the 
teeth. Sometimes other matters mixed with it give a green or bluish color. 
Subjected to dry distillation, it yields hydrocyanic acid and carbonate of am- 
monia, a thick, disagreeably smelling oil, and leaves a spongy charcoal. It 
burns with a greenish-blue flame, emitting at the same time a characteristic, 
acid, disagreeable odor. Its other properties are named above. In the ex- 
amination of a cystic calculus, if a small portion be placed upon platinum 
foil and burned, it may be recognized by the greenish-blue flame, the thick, 
white fumes, the peculiar sickening acid garlicky odor, and by its staining 
the platinum surface of a dark greenish-blue color, which disappears under 
further heating. Cystine, similar to taurine or choleic acid, is a sulphurous 
substance, containing 25 per cent, of sulphur, and appears to form under the 
influence of active emotions, fatigue, prolonged watchings, etc. Its clinical 
importance is not known, further than the danger of the formation of gravel 
and calculus. 

Cystirrhea. Catarrh of the bladder. 

Cystitis. Inflammation of the bladder. 

Cystolithic. Uric vesical calculi, or pertaining to such calculi. 

Cystorrliagia. Hemorrhage proceeding from the blood vessels of the 
bladder. 

Cysts of Echinococci. Cysts containing hydatids (Echinococeus hominis) 
are occasionally formed in the kidneys, varying in size from 2 to 30 milli- 
metres ; they are filled with a fluid and some granular matter, in the latter 
of which fragments of the echinococcus may be found. The cysts have an 
external wall, varying in thickness from 0.22 to 2.5 millimetres, according to 
the size of the cyst, and which, under the microscope, appears to be formed 
of numerous chin layers of structureless membrane. The innermost mem- 
brane, termed germinal, is thin, transparent, tough, and homogeneous, and in 
which the echinococci are developed, being very small, ovoid, animated 
beings, barely visible to the naked eye. These beings are stated to constitute 
the " encysted phase " in the development of a minute tapeworm frequently 
found in the dog; they consist of a caudal vesicle furnished with a pedicle 
for attachment, and a tenia-like head furnished with four suckers and a 
double crown of hooklets. Each cyst may contain six, eight, or ten of these 
beings, or it may be barren. It is extremely rare that these cysts are found 
entire in the urine discharged, being ordinarily partially or wholly disin- 
tegrated, so that the hooklets alone may, or may not be detected, and, per- 
haps, flakes of membrane, and fragments of cysts. In the passage of these 
from the kidneys to the bladder, various unpleasant and painful symptoms 
are sometimes experienced, as well as during their discharge through the 
drethra. The detection of these hyatids or their fragments in the urine, 
6 



CYT 82 DOU 

would indicate their development in the kidneys, or in the vicinity of the 
urinary apparatus. 

Cytoid. Like a cell or corpuscle. A term applied to cells of similar 
aspect and nature to the white corpuscles or leucocytes observed in blood, and 
which are found in lymph, mucus, chyle, pus, etc. 



D. 

Damaluric Acid. An acid discovered in the urine of man, the cow, and 
the horse, by Staedeler. It is an oi]y fluid, heavier than water in which it is 
slightly soluble, has a valerianic acid odor, reddens litmus, and forms salts 
with bases, and is supposed to be one of the odorous matters of urine. 

Damolic Acid. An acid discovered in urine by Staedeler, and, like the 
previous one, supposed to be one of its odorous principles. 

Detritus. The residuum of worn-out or disorganized tissues, considerable 
of which, in the animal system, is eliminated through the urine. 

Diabetes. Glucosuria. Glycosuria. A. disease characterized by excessive 
thirst, progressive emaciation, and abundant discharges of urine containing 
grape sugar, and termed " diabetes mellitus." When the saccharine matter 
does not exist in the abundant urine, it is termed "diabetes insipidus." 
Sulphide of calcium ^th grain, and sugar of milk 3 grains, mixed and given, 
for a dose, and repeated three times daily, has been found serviceable in 
diabetes. 

Diuresis. A profuse discharge of urine. 

Divulsio Urinse. Urine that is slightly turbid or cloudy. 

Double Staining is a process by means of which blood corpuscles, cells, 
casts, and the various tissues of the human body, are brilliantly and per- 
manently colored for microscopic investigation ; some tissues assuming a 
green, and others a blue, red, or pink color, under the process. It was intro- 
duced by F. Merkel, of Germany, and improved upon by Drs. W. F. N orris 
and E. O. Shakespeare, of Philadelphia. The fluids employed are : — 1. Take 
of pure carmine 10 grains, pulverized borax 40 grains, distilled water 10 
fluidrachms and 40 minims. Place the articles in a glass or Wedgewood 
mortar, and rub them well together ; let the mixture stand for 24 hours, 
carefully pour off the clear liquid, and keep it in a well closed vial. Stains 
red. — 2. Take of indigo-carmine 40 grains, pulverized borax 40 grains, dis- 
tilled water 10 fluidrachms and 40 minims. Prepare similar to 1. Stains 
blue. The sections to be stained, having been first hardened, if necessary, and 
well washed with water, are soaked for 2 or 3 minutes in alcohol, and are 
then placed in a liquid composed of equal quantities of the above two fluids. 
After remaining in this liquid about a quarter of an hour, they are removed 
and at once placed in a saturated solution of oxalic acid, from which they 
are also removed in about 10 or 12 minutes, and washed with water until the 



DEO 



83 



EPI 



washings are neutral. The stained sections, cells, or corpuscles may subse- 
quently be mounted in Canada balsam. Mr. W- H. Walmsley of Philadel- 
phia prepares very beautifully double-stained vegetable, and other, tissues. 

Dropsy, Renal. Dropsy due to renal disease. 

Dumb Bells. See Oxalate of Lime. 

Dysuria, A painful, difficult emission of urine, usually accompanied 
with a sensation of more or less heat or scalding. 



K. 

En.Torcma. The pendulous cloud or nubecula observed in urine while 
cooling. 

Enuresis. Involuntary micturition ; incontinence of urine. 

Epinephelos. Urine that presents a cloudy appearance. 

Epistasis. Substances that float upon the surface of urine. See Hypostasis. 

Epithelial Cells. See Epithelium. 

Epithelium. The thin, delicate 



which consists of minute 
cells of different forms The 
flattened form of epithelium 
is termed scaly; that from 
the vagina and external part 
of the female urethra, con- 
sists of large, irregular, and 
frequently uneven, ragged- 
edged cells, each containing 
a distinct nucleus, and if 
acetic acid be added to them, 
the granules within the cells 
become more indistinct. The 
cells are frequently folded 
over at the sides. See Fig. 1 6. 
The epithelium from the 
urethra is termed columnar, 
prismatic, or cylindrical, and 
is generally mixed with that 
in the vicinity of the meatus 
which is chiefly of the scaly 
form. See Fig. 22, page 129. 
Around the prostate they 
are fusiform, caudate, and 
irregular. The epithelium 
from the bladder varies ac- 



covering of mucous surfaces, and 
Fig. 17. 




A. Glandular epithelium from the kidneys. 

B. Tesselated epithelium from the pelvis of the kidney. 

C. Epithelium with large and distinct nuclei, from the 

ureters. 

D. Columnar epithelium, from the fundus of the blad- 

der. 

E. Large flattened cells, with a very distinct nucleus 

and nucleolus, from the trigone of the bladder. 

F. Epithelium from the bladder. 



EP1 84 EPI 

cording to the part from which it is derived ; from the fundus, it is columnar, 
mixed with large oval cells {Fig. 17) ; from the trigone, the cells are large, 
flattened, and have a distinct nucleus with nucleoli. {Fig. 17.) The epi- 
thelium from the ureters, is of the columnar variety, with a large and distinct 
nucleus ; some are fusiform. (See Fig. 17.) The epithelium of the convolu- 
ted portion of the tubes, is termed glandular or secreting ; the spherical cell is 
nearly double the size of a blood globule, contains a large, distinct nucleus 
surrounded with an apparently granular substance, — the outline of the cell, 
or cell membrane, is very indistinct. In the straight part of the urinifer- 
ous tube, the epithelium is flatter, more resembling the scaly form, and with 
a more distinct outline. The epithelium from the pelvis of the kidney is of 
the tesselated or pavement variety, consisting of small, round, and oval, thin flat 
scales, or cells, united at their edges without overlapping each other. 
{Fig. 17.) 

These epithelial cells, from the mucous membrane lining the urinary 
passages, are found in larger or smaller quantity in normal urine, and in 
urinary sediments; sometimes these epithelia are isolated, at other times 
they are contained in mucus blood, or pus. They may be found in the ense- 
orema or mucous filaments of normal urine, mixed with some rare mucous 
globules, with granulations of urates, or, with ammonio-magnesian-phos- 
phatic crystals among persons who drink alkaline waters, the whole being 
held in a small quantity of mucus. — When found in the sediments, they are 
lost in the midst of organized or other elements that form the mass of the 
deposit. By treating the deposit with acetic acid, the phosphates and the 
urates are dissolved (precipitated uric acid appearing only after a short 
time), and the deposit becomes clear. The epithelial cells can now be 
readily distinguished, by their form and size, from other organized elements. 
Yellowish epithelial cells present in urine would lead to testing for biliary 
coloring matters. 

Diagnosis. Epithelial cells must not be confounded with leucocytes or 
blood globules, which are much smaller; with urinary casts, which have a 
special form and are much larger; nor with the spores of fungi, and certain 
voluminous infusoria (volvox). In some rare cases, cancer cells, or tubercu- 
lous masses may be taken for epithelia, and reciprocally. But other symp- 
toms enable us to diagnose the cancerous or tuberculous affections of the 
urinary passages, long before their elements appear in the urine. Sometimes 
the strangeness and the variety of the cellular forms found in the urine are 
such that a mistake is not possible; for instance, in cancer of the uterus with 
propagation to the bladder. — It is not always possible to satisfactorily deter- 
mine the precise origin of each epithelial variety met with in the urine, 
because of the diversity of their forms, and the very variable dimensions of 
the epithelial cells of the urinary mucous membrane. It will be attempted in 
the following table to classify their distinctive characters, so that when these 
type forms are found, one may be enabled to trace them to their origin. 



EPI 



85 



EPI 



VII. Table of the Typical Characters of Epithelial Cells met with in 

the Urine. 



1. Bound or oval 
epithelial cells, a little 
swollen. 



2. Epithelial cells 
lamellar, very thin 
polygonal. 



Very large (0 mm .01 6 f 
to mm .0.33) with a sin- J 
gle lar°:e nucleus, ordina- j 
rily Omm.011). [_ 

With 2 nuclei, or one f 
nucleus and nucleiform -j 
granulations. ( 

Much smaller (about J 
mm .011 to mm .015). j 

A large nucleus, and 
often two nuclei and nu- 
cleiform granules. 

Very large lamella? (0 
mm .022 to mm .045) 
but with very small nu- 
cleus (0 mm .006). 



Urethra. 

Bladder (has fond). 

Pelvis of the kidney. 
Ureters (superficial lay- 

Kidney (rarely in an 
isolated state). 

Bladder (near the neck). 

Pelvis of the kidney and 
ureters (superficial lay- 
er). 

Vagina, and external 
genital parts. 

Urethra (near the exter- 
nal orifice). 



3. Cylindrical, fusi- 
form, or battledore | 
epithelial cells, with -j Bladder. Pelvis of the kidney. Ureter; 
tail longer or shorter j 
and more or less bent. [ 



Of course, this table can not be an absolute guide for the diagnosis of epi- 
thelia; intermediary forms and dimensions exist that escape any classifica- 
tion ; we have had especially in view the indication of some starting points, 
so that, in the midst of these capricious elements, one may be enabled to 
bethink himself. No dismay should be felt at the measurements, as the mi- 
crometer of the microscope will readily determine them ; beside, by taking as a 
measure of comparison, with the same magnifying power, the dimensions of 
a leucocyte or of a blood globule, it becomes very easy to appreciate the 
differences in size of the epithelial cells, with sufficient precision. 

Examination of Epithelia. Be it understood that, we suppose the general 
characters of epithelia and of the structure of the urinary mucous membrane, 
are known, and will, therefore, merely indicate a very simple method by 
which epithelia may be procured from the urethra during life. With indi- 
viduals who have just undergone a sitting for dilatation of the urethra by 
bougies, upon compressing the canal a milky fluid escapes, consisting of oil 
globules, leucocytes, and a mass of epithelial cells detached from the urethral 
mucous membrane by the repeated frictions. But it is much better to intro- 
duce a bougie, coated with glycerin, to a certain depth in 'the urethra, allow 
it to remain a few minutes, and then after having withdrawn it, compress the 
canal ; it is useless to pass the bougie as far as the bladder. Sufficient epi- 
thelia will thus be procured for examination, and without the non-desirable 
oil globules. And upon these epithelial cells maybe practised their mensur- 
ation. — To obtain vesical epithelia not mixed with that from the urethra, 



ESB 86 ESB 

practise catheterism when there is but a small amount of urine in the blad- 
der, and in the urine thus collected will be found more or less cells. 

% Action of Reagents. While acetic acid develops two, and more commonly 
three, nuclei, in leucocytes, it simply causes the nuclei of epithelial cells to 
become more conspicuous by rendering the protoplasm surrounding them 
paler. — Carmine colors epithelia quite well when they are not too granular. 
A very excellent reagent is the picrocarminate of ammonia, prepared as di- 
rected under Ammonia. If a drop of this coloring reagent be added to a 
sample of epithelia, on a glass slide, their nuclei will assume a delicate rose 
tint, while the rest of the cell will be pale yellow. 

Clinical Import. — An increased amount of epithelium from the urethra indi- 
cates catarrhal or specific inflammation of the walls of this canal ; from the 
bladder, more or less catarrhal inflammation of the lining membrane of this 
viscus; from the vagina, leucorrhea, or specific inflammation. When epi- 
thelia are found in the urine, coming from the ureters or kidneys, a more or 
less serious affection of these organs is indicated according to the amount of 
cells present, in connection with albumen, blood, renal casts, pus, and local 
or constitutional symptoms. For numerous plates showing these various 
epithelia, with important information regarding their indications, treatment, 
etc., the reader is referred to " Basham on Dropsy," and " Johnson on Dis- 
eases of the Kidneys." 

Esbach's Method. This is a quick and accurate process for the quanti- 
tative analysis of urea, devised by M. Esbach, of the Necker Hospital, Paris, 
who claims that the results obtained do not vary more than 1.6 per cent. 
The apparatus employed is as follows : — 

1. A generator, consisting of a cylindrical glass tube, having a bulb blown 
upon its upper third, to the capacious neck above which a ground glass stop- 
per is very accurately fitted. From the upper part of the bulb a narrow 
tube passes, permitting communication between this part of the generator 
and the top of the gasometer. At the bottom, the generator is closed, and is 
attached to one side of the gasometer, at about its middle, by means of a 
solid glass stem. A small test tube, capable of holding 1.5, or 2, c. c. of urine, 
accompanies the instrument, and which is sufficiently narrow to be readily 
introduced within the neck above the bulb. — 2. A gasometer, likewise a cylin- 
drical glass tube, about twice the length of the preceding one, and somewhat 
larger in diameter, graduated, open below, and communicating, at its top, 
with the generator, by means of the narrow tube above referred to. — 3. A 
baroscope, consisting of a barometer U tube, with its open extremity drawn 
out to a fine point, and its closed end dilated into an elongated bulb in which 
is contained a chemically inert gas ; this gas is separated from the atmos- 
phere by a column of mercury, above which is a drop of water that keeps it 
always in a state of saturation. Here are realized the conditions under which 
a gas is collected in the presence of water. The graduation of this instru- 
ment expresses the resultant of the atmospheric pressure, temperature, and 
aqueous tension. 



ETH 87 ETH 

The reagent (sodium hypobromite) is prepared by carefully measuring and 
adding together water 60 c. c. and bromine 2 c. c., and then, sodic hydrate 
(36°) 40 c. c. As this is not a permanent mixture, it is better to prepare it 
as needed. Some care should be had to avoid the irritating vapor of bro- 
mine, which maybe effected by covering the bromine, in its flask, with water, 
and removing therefrom the quantity required by means of a graduated 
pipette. 

The manner of using is as follows : A glass jar, sufficiently large to contain 
the instrument (generator and gasometer combined) in a vertical position, 
and with an arrangement near its bottom into which the gasometer may be 
fitted, rendering it immovable in any direction except upward and down- 
ward, is filled with sufficient water; the instrument is immersed in this water 
to a depth that will bring the level of the water, measured by the lower line 
of the meniscus, to a mark made on the narrow tube forming a communica- 
tion between the generator and gasometer. This having been done, by means 
of a small glass funnel, pour the reagent into the generator until it rises as 
high as to the commencement of the lower part of its bulb. Now quickly 
introduce, with the thumb and index finger of the left hand, the small, nar- 
row test tube into which 1 c. c. of the urine has been previously added, and 
immediately close the generator air tight by its glass stopper, at the same 
time dexterously pushing down the narrow test tube by means of the knob- 
like end of the stopper. The evolution of nitrogen commences at once, with 
considerable violence ; to relieve the pressure the instrument is raised up- 
wards, but not out of the water. The water in the gasometer sinks, as it is 
lifted up, and causes an aspiration, thus facilitating the disengagement of the 
gas. In about a minute the reaction is completed. The gasometer is now 
pushed downwards until the level of the water, inside and outside of it, 
coincides, and the value of the gas is then read off on the graduations of this 
tube. Now correct for temperature, barometric pressure, and tension of aque- 
ous vapor, and it will be found that 1 centigramme of urea gives 3.4 c. c. (or 
34 divisions) of nitrogen at 0° and 760 millimetres. To avoid all these neces- 
sary calculations, the baroscope is consulted, and the true percentage of urea 
present is ascertained by referring to the baroscopic tables accompanying the 
instrument. 

Should albumen be present in the urine, as it is also decomposed by the 
reagent it should be separated, by boiling the urine in a test tube, and then 
filtering; if, however, the urine be alkaline, it must first be acidified by the 
careful addition of. a drop or two of acetic acid. Uric acid, also creatinine, 
are decomposed by the reagent, but more slowly and not so instantaneously 
as urea, hence, any error from this cause would be inappreciable. — W. Brewer, 
No. 43 Hue St. Andre"-des-Arts, Paris, furnishes these instruments and the 
baroscopic tables. 

Ethereal Solution of Peroxide of Hydrogen. Ozonic Ether ? Satu- 
rate rectified ether, to which a small amount of alcohol has been added, with 
a strong solution of peroxide of hydrogen ; agitate gently, allow it to rest for 



EXT 88 EXT 

a time, decant the ethereal solution, and keep it in well stoppered vials. 
This solution will keep for many months without deterioration, and, as it is 
highly inflammable, it must not be brought near a light, or fire. This is 
used in medicine as a disinfectant, stimulant, etc., and is frequently employed 
as a test. Richardson. 

Solution of 'peroxide of hydrogen may be made as follows: 1. Dissolve finely 
powdered peroxide of barium in dilute hydrochloric acid to saturation. To 
the solution, when filtered and cooled, add baryta water until the silica and 
foreign oxides have been thrown down, and a faint precipitate of hydrated 
peroxide of barium appears. Again filter to remove the precipitates, and to 
the clear solution add a quantity of strong baryta water, which precipitates 
crystalline hydrated -peroxide of barium. Collect this precipitate on a filter, 
pour on water until the washings are free from hydrochloric acid, and pre- 
serve it in a moist state in well stoppered glass vessels. 

2. Treat the moist hydrated peroxide of barium with dilute sulphuric 
acid, constantly stirring, and adding the acid gradually, and continue this 
process until only a trace of free acid remains. Allow the sulphate to sub- 
side, filter the liquid, and then cautiously remove the slight excess of acid 
by the careful addition of dilute baryta water. Keep this solution of peroxide 
of hydrogen in well closed vessels. Jul. Thomsen. 

The presence of peroxide of hydrogen in the fluid may be determined by 
the following methods : — a. Add a few drops of the solution of ammonio- 
nitrate of silver, wholly free from excess of ammonia, to some solution of 
peroxide of hydrogen, and then expose the mixture to a boiling heat ; instant 
turbidity will appear, from the silver being reduced to its metallic state. 
Boettger. — b. Dissolve calcined titanic acid in boiling sulphuric acid, and then 
pour the solution into a large quantity of pure water; filter, to remove the 
precipitated hydrated titanic acid, wh^ch must at once be redissolved in dilute 
sulphuric acid. If a small amount of peroxide of hydrogen in solution be 
added to a little of this titanic acid mixture, it will develop an orange or 
yellow color. Schozn. — 3. Fresenius states that a " solution of peroxide of 
hydrogen may be easily prepared by triturating a fragment of peroxide of 
barium (about the size of a pea), with some water, and adding it, with stir- 
ing, to a mixture of about 30 cubic centimetres of hydrochloric acid and 120 
cubic centimetres of water. The solution keeps a long time without suffer- 
ing decomposition." 

Extractive Matters. Imperfectly defined animal matters, pre-existing 
in the blood, and met with in the urine when certain pathological conditions 
are present. Dr. Owen Rees recommends tincture of galls to be added to the 
urine (from which albumen, if present, should be removed by coagulation 
and filtration), which immediately causes a precipitate of these matters ; after 
five or ten minutes, another precipitate ensues which is due to the action of 
the alcohol in the tincture upon the potassa and terreous salts. These ex- 
tractives do not exist in normal urine. Their presence is indicative of some 
active lesion in the urinary apparatus, which permits these matters to transude. 



EXT 89 EXT 

In albuminaria, the extractive substances exist in the urine for some 
time previous to the presence of albumen, and also subsequent to its disap- 
pearance; thus enabling us to detect the malady in its incipient period, as 
well as to determine the necessity for a further continuance of treatment ; as 
long as they exist in the urine, the prognosis is unfavorable. They may be 
found in urine at a very early period, when renal congestion or irritation 
exists, but are absent in nephritic calculus. 

It may be proper to state that two orders of elements have been designated 
by authors as extractive matters : One, crystalloids, capable of detection and 
possessing well known chemical properties, as, creatinine, hippuric, succinic, 
phenic, taurylic, damaluric, and damolic, acids, etc., existing in normal 
urine ; the other, observed only in pathological urine, as lactic, and butyric 
acids, allantoin, leucin, tyrosin, xanthin, hypoxanthin, etc. The source of 
these extractives is found in the incessant molecular destruction of the 
tissues ; this origin is common to them together with urea and uric acid. 
They are the products of disassimilation having attained different degrees of 
oxidation, and may be said to represent, as it were, the ashes of the animal 
focus. Their physiological part is finished, they can no longer serve either 
in nutrition or in the formation of new tissues, and they are expelled as 
foreign bodies of no utility. The condition in which they are found indicates 
a weakness of the organism powerless to convert them into urea, the last 
degree in the scale of oxidations. Their presence in the urine, even in its 
physiological state, fully settles this view. 

One is reluctant to admit, and it is contrary to the sound ideas of physi- 
ology to suppose, that, in an organism normally performing its functions, 
the histological elements do not attain their complete evolution. If, in the 
normal state, we encounter in the excrementitial fluids bodies of various 
degrees of oxidation, it is because they are qualified to appear in them, and 
they there occupy their natural and legitimate place. The difference of their 
origin (fibrous, muscular, nervous, parenchymatous, tissue) explains the 
multiplicity of their forms. In fevers, in the urine of which these extractives 
are always present in a plus or minus degree, a constant and most prominent 
character of commencing and progressive convalescence is a diminution of 
their quantity [as well as of that of uric acid], and an increase of chloride 
of sodium ; this diminution of the extractive matters would appear to prove 
that the oxidation of the nitrogenous substances in the organism was more 
perfect. The increase of the chloride of sodium is probably due to the 
stronger and more extensive diet of the convalescent. 

Hepp comprises under the term " extractive," the group of organic mat- 
ters found in the urine, with the exception of urea and uric acid, in cases 
where we may determine these last separately. Chalvet designates as ex- 
tractive matters, both of the blood and the urine, all the elements, with the 
exception of urea, that are soluble in absolute alcohol. 

Extraneous Matters in the Urine. These are of two classes : 1. 
Those bodies that accidentally enter the urine after it has been discharged 



FAT 90 FAT 

from the bladder, as, hair of various kinds, fragments of linen, cotton, silk, or wool, 
of tea leaf, of starchy of feathers, of wood splinters, of oil globules, of chalk, and of sand. 
• — 2. Those substances that enter the urine previous to its elimination, as, color- 
ing and odorous matters from food, or medicinal agents, as, copaiba, rhubarb, 
iodine, lead, mercury, etc. The physician should especially make himself familiar 
with the character and appearance of those belonging to the first class, by micro- 
scopical examinations of them outside of the urine, that he may not be led into 
error from their presence in this fluid. Caustic potassa, or soda, 5 or 10 parts 
to 100 of water, dissolves wool and silk, but not flax, hemp, or cotton. Neutral 
chloride of zinc at 140° F., dissolves silk. Ammonio-oxide of copper dis- 
solves the cellulose of cotton, hemp, and flax, but does affect silk or wool. 



F. 

Fatty Matters. These are occasionally found in the urine in different 
states, as, in a molecular state, noticed under chylous urine; in the form of 
concretions (urostealith) ; and in the form of globules, as when milk or fat is 
added to the discharged urine, or when derived from the organism, existing 
in the urine in a free state, entangled in renal casts, or, in the form of fat 
cells. Sometimes, being dissolved by other constituents in the urine, a chem- 
ical examination alone will be able to detect it. When the fat is observed to 
float upon the surface of the urine, it may be derived from within the organ- 
ism, but should remind the practitioner that its presence may also be the 
result of catheterism, use of unclean urinary vessels, or, of design. — When 
the fat is held in the urine in the form of drops, in suspended granules, 
enclosed in epithelial cells, or in the products of exudation, renal casts, it 
indicates a probable fatty degeneration of the kidneys, or of the epithelial 
covering of the urinary apparatus, or, according to C. Bernard, an excess of 
fat in the blood. 

Fat or oil globules when once seen and studied under the microscope, will 
never be confounded with any other substance. They present the form of 
smooth, roundish, flattened disks; sometimes, when compressed, polyhedral ; 
they strongly refract light which gives them a sharp, dark outline with 
transmitted light, and, with reflected light, a whitish center, and a shining 
silvery outline. See Fig. 22, page 129, and large organic globules, Fig. 30, 
page 163. A good method of accustoming one's self to recognize these glob- 
ules in this fluid, is to strongly agitate some freshly voided urine, with a little 
milk, and then examine a drop or so under the microscope. If a urine con- 
taining fat be evaporated to dryness over a water bath, and some ether be then 
added to the residue, it will dissolve the fat, and on being allowed to evapo- 
rate spontaneously, the ether will disappear, and the fat will remain. A few 
drops of this on fine paper will leave a permanent grease spot ; it may also 
be tested chemically. 



FAT 91 FAT 

Remarks an Fats. The immediate principles constituting the suets and the 
fats, present no crystalline form in the organism, and can not be separated 
by the scalpel, nor by washings with water. These principles possess prop- 
erties so similar, that great efforts are necessary to enable one to separate 
them from each other, that is to say, to analyze the tissues which they form 
by their combination. Suets, indeed, present organic characters which, as 
far as known, have their analogue nowhere else. Thus, it is recognized that 
the suet of beef, for instance, is composed of three substances, — stearin, mar- 
garin, and olein. Two of these substances are solid and melt only at an 
elevated temperature; the third, olein, is a fluid substance, a limpid oil, 
solidifying only at a very low temperature. It would seem that nothing 
could be more simple than to extract this oil by pressure, or by prolonged 
contact with some porous body, such as bibulous paper ; but it is not so, 
whatever care may be taken, it will be impossible to remove from the suet a 
trace of olein. If bibulous paper be greased by pressure at a gentle heat, the 
portion of the grease retained by the paper will be equally composed of 
the mixture of the three substances, and in the same proportions as they ex- 
isted in the suet before the experiment. 

In the analysis of a fatty tissue, the first thing is to extract its suet ; for this 
purpose, the fatty matter must be macerated in boiling water, and be broken 
up to remove the suet contained in the cells. The fat, set free, floats upon 
the surface of the water, forming a cake on cooling, which is to be removed. 
Suets always contain olein, stearin, and margarin ; the latter two vary in 
quantity according to the nature of the tissue, the part of the body from 
which it is taken, and according to the animal to which it belongs. — In order, 
therefore, to be enabled to distinguish these principles, a small portion of the 
cake of suet must be dissolved in boiling alcohol. As the alcohol cools, but 
before it is completely cold, crystals of stearin will be observed to form first ; 
a short time after, the margarin crystallizes. These two substances may be 
readily distinguished under the microscope. The olein remains in solution 
in the alcohol, and some of it is likewise attached to the crystals of stearin 
and margarin, from which it may be removed by pressing these between 
sheets of bibulous paper which absorb the olein, and from which it may be 
extracted by ether. 

In certain cases this mode of analysis may suffice, but it is generally 
preferable to transform the suet into a soap, by boiling it with a dilute 
solution of soda or potassa ; the olein, margarin, and stearin, then become con- 
verted into oleic, margaric, and stearic acid, combined with the base employed. 
This solution of soap is then decomposed by hydrochloric acid, and now the 
characters of oleic, stearic, and margaric acids, which it is greatly more easy 
to separate from each other, are much more clearly marked, than the olein, 
stearin, and margarin, from which they have been derived. — To separate 
these three acids, dissolve the mixture in boiling absolute alcohol. While 
cooling, stearic acid crystals form, and may be removed ; when cold, those of 
margaric acid form, and the oleic acid remains in the solution. The crystal- 



FEA 92 FIB 

line acids may be thoroughly separated from each other by successive crystal- 
lizations, and be examined microscopically. — Stearic acid melts at 167° F., 
and margaric acid, at 132° 8 / F., and the acid that will melt at just one of 
these points of fusion, may be considered perfectly pure. — To obtain the 
oleic acid pure, saturate it with a little litharge to form a soap of lead, dis- 
solve this in ether, and by means of sulphureted hydrogen decompose the 
oleate of lead, and a perfectly pure oleic acid will be the result. Stearate 
and margarate of lead are not soluble in ether. 

Feathers. Fragments of feathers are frequently observed in urine, prob- 
ably derived from the bed or pillows. They may be recognized by the shaft 
of the feather, and the branched character of the barbs proceeding from it. 

Febling's Solution. See Copper. 

Fermentation. See Alkaline Urine. 

Fibrin. Fibrin is sometimes met with in urine. It occurs in bloody 
urine, either in the form of more or less voluminous clots, including some 
blood corpuscles and leucocytes, or, in the state of colorless coagula, some- 
times solid, at others, gelatinous. The fibrinous coagulum is sometimes so 
large that it can not possibly be attributed to the blood in the urine as its 
sole origin. Vogel relates the case of a woman affected with Bright's disease, 
whose urine, several hours after its emission, presented a fibrinous coagulum, 
of a very pale-red color, at the bottom of the vessel. This coagulum con- 
tained too few globules to attribute its presence to anything else but an ab- 
normal exudation of the fibrinous fluid (blood plasma). — In certain cases of 
cantharidal cystitis consecutive to the application of large blisters, shreds of 
pseudo-membranes are found in the urine, or greyish fibrinous pellicles, often 
accompanied with vesical mucus, leucocytes, and some blood corpuscles. 

Under the microscope, coagulated fibrin possesses somewhat different charac- 
ters, according to its age. Shortly after its coagulation it presents a very 
distinct fibrillary aspect, more or less like felted network, and slightly gran- 
ular. After a short time, the fibrillary disposition disappears, and then the 
fibrin is seen in the form of a granular, amorphous matter, with or without 
a lamellar and stratified tendency, or else, it separates into small granular, 
split fragments, and more frequently polyhedric, irregular, with blunt angles. 
— Certain filaments of mucus floating in the urine, and presenting a fibrillar 
or striated appearance may be mistaken for fibrin. All doubt may be 
removed, by adding a little acetic acid to them, which does not change the 
aspect of the mucus (it rather increases the striation), while it causes the 
fibrin to swell, rendering it gelatiniform and transparent, thus allowing an 
examination of the anatomical elements imprisoned by it during its coagula- 
tion, as, epithelia, leucocytes, blood corpuscles. The presence of fibrin in 
the urine indicates an exudation of fibrinous fluid from some part of the 
surface of the urinary apparatus, more generally of the kidneys. 

Fibrinous Calculus. Calculi have been called fibrinous, from having 
given the chemical reactions of fibrin. They are sometimes hard and brittle, 
or, like wax, of a yellowish-brown, or dark-reddish-brown color, rough, 



FIL 93 FUC 

uneven surface, soluble in potassa, from which the fibrinous substance is pre- 
cipitated by an excess of acid ; soluble in acetic acid under heat, which solu- 
tion gives a precipitate with ferrocyanide of potassium. A red heat leaves 
very little residue, but when blood is also present, iron may be detected in 
the ash. These calculi are very rare. 

Filamentous Urine. Urine in which are observed filamentous or thread- 
like matters. 

Filter. In all cases of filtration the best chemical filtering paper should 
be employed, and as it is frequently the case that the filter has to be ignited 
with the precipitate remaining on it, the best method is to cut a number of 
small filters, of the same size exactly, and from the same sample of filtering 
paper, and keep them in a covered box where no particles of dust can collect 
upon them. To determine the weight of the ash of such filters with sufficient 
accuracy for analytical purposes, ten of these filters should be ignited until 
every trace of carbon is consumed ; then weigh the resulting ash, and divide 
the weight found by ten, which will give, with sufficient precision, the aver- 
age quantity of ash left by each filter upon incineration, and which amount 
is to be deducted from the weight of the residue remaining after ignition of 
a precipitate and filter. — When there is no danger of a reduction of the pre- 
cipitate by the action of the carbon of the filter, the precipitate with the 
filter are burned together. When there is danger that such reduction may 
occur, the precipitate and the filter are separately ignited, having first 
removed as much of the former from the latter as possible. The two ashes 
are then united and weighed, deducting the weight of the filter, as stated 
above. 

Flax Fibres. Fragments of linen in the urine present the striated aspect 
of the woody fibrous portion of the flax entering into their composition. 
The fibres are jointed at intervals, have a round, solid appearance, and their 
broken ends look like a brush composed of minute fibrillse. They are slowly 
soluble in ammoniacal solution of copper, but are not soluble in liquor potassa 
or soda. 

Foreign Bodies in Urine. See Extraneous Matters in the Urine. 

Fnchsin. Anilin Med. Take of crystallized fuchsin 1 centigramme, abso- 
lute alcohol 20 to 25 drops, distilled water 15 cubic centimetres; mix. This 
colors almost instantly, and without altering the tissues. It is especially 
adapted for the study of epithelia and pale delicate cells, rendering them 
more distinct. If a drop of this red solution be dropped upon a preparation 
of elastic fibres, all the elements become colored, but as soon as the prepara- 
tion is washed with distilled water acidulated with acetic acid, the color dis- 
appears, and remains only upon the elastic fibres. This reaction is useful in 
determining and characterizing the elastic fibres in certain specimens of ex- 
pectoration. Alcohol, however, soon extracts this coloring matter from the 
specimen. — Half a grain of fuchsin dissolved in four fluidraehms of distilled 
water, is preferred by many microscopists to the mixture with alcohol, or 
with acetic acid. 



FUN 94 GLU 

Fnngi. These are vegetable growths found in urine, after it has stood for 
some time, none of which, with the exception of sarcinse, are in the urine 
when voided ; the most common are the penicilium glaucum or mould fungus, 
the lorula cerevisice, yeast or sugar fungus, and the sarcince ventriculi. See 
Vegetable Organisms. The spores or reproductive organs of these are what we 
find in urinary deposits. According to Van Tieghem (Becherches sur la fer- 
mentation de Puree et de Vacide hippuric, Paris, 1864), the alkaline fermenta- 
tion of urine is due to the development of a torulace consisting of globular 
cells united in the form of beads; these cells being very small (0 mm .001), 
are not granular, and no difference is found between their envelop and their 
contents. This ferment multiplies by gemmation, and it is never developed 
upon the surface of the liquid, but in its interior, or upon the walls of the 
vessel containing it. It is found mixed with the white deposit formed by the 
precipitated salts. — The organs of vegetation (mycelium) composed of more 
or less partitioned and ramified tubes, are only met with in urine left for 
a long time to putrefaction. 



G. 

Gallic Acid. J Add a little cane sugar to the urine, and when dissolved 
dip a strip of filtering paper into the fluid and allow it to dry. If now, by 
means of a glass rod, a drop of concentrated sulphuric acid be placed upon 
the paper, an intense violet color will be produced, if gallic acid exists in the 
urine. 

Gamboge. This substance taken internally will impart a yellow color to 
urine. 

Garlic. The ingestion of garlic, as well of onions, communicates a pecu- 
liar odor to the urine, with an increased amount, in some instances, of crystals 
of oxalate of lime. 

Gas in Urine. According to M. Morin 100 volumes of urine contain on 
an average 2.44 volumes of gas, consisting of carbonic acid 65.40, oxygen 
2.74, and nitrogen 31.86. The first named, being a product of combustion, 
has its percentage increased after violent exercise. 

Globules. The blood globules are red, and among them are found pale 
or white globules called leucocytes, in the proportion, in a normal state, of 2 
or 3 to 1,000 of the red globules. Bernard considers the red globules to be 
the respiratory element of the blood, and the white its plastic element. 

Globulin. The colorless, albuminous fluid, or coagulable matter of the 
blood corpuscles. 

Glucogene. Hepatic Dextrine. An animal starch, strongly resembling 
that from the vegetable kingdom ; all albuminous substances must pass 
through the transitional stage of glucogene, before they can be converted 
into sugar. 



GLU 95 GUA 

Glucose. Fruit Sugar. Fructose. By ?ome the term is applied to grape 
sugar. It is the uncrystallizable sugar of honey, grapes, and fruits, but not 
found in diabetic urine, although frequently used to express the saccharine 
matter in that fluid. Glucose may, however, be converted into grape sugar 
by molecular changes. See Grape Sugar; Sugar. 

Glycerin. This agent renders almost all histological elements more 
transparent, and has a somewhat analogous action in this respect to acetic 
acid. It renders nuclei and elastic fibres very evident, in the midst of elements 
it has caused to swell and become more transparent. It is very useful in the 
investigation of hairs which it clears so as to allow the detection of vegetable 
parasites which at times infiltrate their roots, and even their medullary canal. 
Mixed with equal parts of acetic acid, glycerin . constitutes a valuable agent 
in the study of all parasites, especially the Acarian. It is also used in com- 
bination with gelatin, and other agents, for preserving or coloring various 
specimens. 

Glycocholic Acid. See Bile Acids. Cholic Acid. 

Glycocoll. Glycocine. Glycin. Sugar of Gelatin. May be artificially ob- 
tained from gelatin by the action of mineral acids; from hippuric acid by 
boiling with hydrochloric acid ; and from cholic acid, which see. It forms 
large, hard, colorless crystals, of the oblique rhombic system, containing 
nitrogen but no sulphur, which are sweet to the taste, dissolve in 3 or 4 parts 
of cold, and less of boiling, water, are unchangeable in the air, and fuse and 
decompose at a high temperature. Glycocoll unites with acids and bases. 

Glycose. Another name for sugar in diabetic urine. See Glucose. 

Grape Sugar. The crystallizable sugar of grapes, fruit, and honey, and, 
likewise, forms the sugar met with in diabetic urine. It may be separated 
from evaporated diabetic urine by boiling the resulting extract in alcohol. 
Grape sugar is white, inodorous, less sweet than cane sugar, gritty between the 
teeth, crystallizes in rhomboidal prisms, soluble in 1^ parts of cold water, freely 
in boiling, insoluble in absolute alcohol, but soluble in diluted, and its solution 
turns a ray of polarized light to the right. At 212° F., the crystals melt and 
lose their two equivalents of water, and at 284° F., they are converted into 
caramel, C 12 H 18 9 . See Sugar. 

Gravel. A minute form of calculi. Small concretions which form in 
the kidneys, pass through the ureters, and are discharged with the urine. 
They more commonly consist of urates and animal matter; occasionally of 
oxalate of lime, phosphates, etc. 

Gravid in. A urinary deposit with pregnant women, the decomposition 
of which, as stated by Stark, results in the formation of the pellicle upon the 
surface of the urine, known as Kiesteine, which see. 

Guanine. A substance occurring in small amount in guano, and also met 
with in human urine. It is one of the intermediate series occurring in the 
regressive metamorphosis of nitrogenized tissues, which terminates in the 
formation of urea, uric acid, and carbonic acid. It is a yellowish-white, 
crystalline powder, without taste or odor, insoluble in water, ether, and 



HAI 96 BLZEM 

alcohol, feebly soluble in hydrochloric acid, and in caustic soda, without action 
on vegetable colors, and can bear a temperature up to 392° F. without 
decomposition or loss of weight. Its reactions are similar to those of xanthine. 



H. 

Hair. This is occasionally met with in urine, rarely originating from its 
formation in the urinary passages, but more frequently in cysts, discharging 
into the bladder ; and much more commonly, from its introduction through 
vesico-vaginal fistula, or designedly. Hair from blankets, from cats, etc., 
is sometimes found in the urine ; the best method for promptly determin- 
ing them, when present, is to examine preparations of various kinds of hair 
under the microscope, that they may not be mistaken for renal casts, etc., 
when in the urine. 

Hsemaphseiii. A name given, by Simon, to the amber-yellow coloring 
matter of healthy urine, and supposed by some to be modified hematin. See 
Urohematin. 

SEseinatin. Hcematosin. Hematin is a coloring matter of the blood, wholly 
distinct from hemoglobin, and is a product of the decomposition of the latter 
blood-coloring substance. It is of a blueish-black color, with a metallic lus- 
ter; the black-chocolate colored, or, coffee-like matters vomited in certain 
affections, owe these dark colors to its presence, as do likewise certain fluids 
in a pathological condition. An old blood stain does not give the spectrum 
of hemoglobin, but that of hematin. Hematin may appear in the urine with 
blood corpuscles (see Blood in Unne), or, the corpuscles may be disintegrated 
and dissolved in the urine, giving more or less color to this fluid, according 
to circumstances (see Urohematin). Alkaline solutions of hematin are of red- 
brown color in mass, and green in a thin layer; acid solutions, present a 
red-brown color whatever may be the thickness of a layer or mass. — Recent 
investigations by Paquelin and Jolly, appear to have shown that blood cor- 
puscles contain iron in the form of tribasic phosphate of the protoxide, and 
that their coloring matter, hematosin, contains no iron whatever. 

Msematinuria. Urine containing not blood corpuscles, but only the 
coloring matters of blood (hematin) ; it is met with in several affections, 
as purpura, malignant scarlet fever, pyaemia, scorbutus, etc. The urine is 
usually of a chocolate color. The blood is supposed to be in a decomposed 
or dissolved condition. 

Hsematocrystallin. Blood (or hemogloblin) crystals, prepared by placing 
a drop of blood on a glass slide, and after an exposure to the air for 10 or 15 
minutes, a drop of water is added, the whole breathed upon 4 or 5 times, 
then covered with thin glass, and allowed to evaporate slowly in sunlight. 
Funcke. It is preferable to use defibrinated blood. The crystals are of the 
prismatic form, belonging to the rhomboidal system, and require from an 



H^M 97 H^M 

hour to several days for their formation, according to the different specimens 
of blood. A spark of electricity passed through blood, also gives rise, after 
a longer or shorter time, to the formation of these crystals; the blood of the 
Guinea pig crystallizes the most readily. 

Hrematoglobin. Hemoglobin, Hemo globulin, Hemaio globulin, Cruorin. 
Terms applied to the red coloring matter of the blood, which is the only 
element of this fluid that contains iron ; it may be separated into globulin 
and hematin. Hematoglobin exists in the blood of all vertebrated ani- 
mals, being enclosed in the red corpuscles of this fluid ; it likewise exists 
in the blood of some of the invertebrata ; but, with a few exceptions, not in 
the form of red globules, but in solution in the plasma, as, with the blood 
of the earth worm. It is found in the blood of some annelids, the larvae of 
certain insects, in branchipus stagnalis, planorbis corneus, etc. 

Disintegrated blood consists of the globulin (the colorless albuminous fluid 
of blood corpuscles), and the red coloring matter of blood, which may, by 
certain manipulations, be obtained in crystals — hozmatocrystallin. Hemato- 
globulin, or disintegrated blood, coagulates at 204.4° F., while albumen 
requires a temperature of about 145° F.; the former, exposed to heat, becomes 
deoxygenated and converted into hematin and globulin. It is not positively 
determined whether the disintegration of the blood corpuscles takes place in 
the circulation, or at some other place (the kidneys) ; but the presence of 
hematoglobin in the urine augurs more or less unfavorably, according to its 
persistency and amount. In typhus, scorbutus, purpura, etc., its presence in 
large amount is an indication of danger, more especially should urinary 
suppression and discoloration of the skin ensue. 

As to the presence of the coloring matters of blood in the urine, without 
blood globules, Vogel gives his opinion as follows : " The passage of the 
hematoglobulin into the urine may be explained thus, — In the organism some 
blood corpuscles are being continually decomposed during the metamorpho- 
sis of the tissues, and consequently hematoglobulin is set free. When this 
metamorphosis proceeds in a normal manner, the small quantity of hemato- 
globulin set free in the blood, is, in its turn, transformed ; the globulin, 
serving for the nutrition of the muscles and other protein tissues, is finally 
eliminated from the body in the form of urea and uric acid. The hematin 
becomes equally changed and oxidized, and, probably, terminates by being 
separated from the organism under the form of urinary and biliary pigments, 
so that when the metamorphosis of the tissues follows its normal course, 
hematoglobulin never- passes into the urine. But when, under pathological 
influences, large quantities of blood globules are suddenly decomposed, the 
amount of hematoglobulin then existing in the blood is so great that the 
whole of it can not undergo the normal. changes referred to above; and, 
under these circumstance, a part of the hematoglobulin may pass unchanged 
into the urine, just as is observed to be the case with other substances not 
ordinarily found in this fluid, as sugar, bile matters, and probably albumen, 
which, when in excess in the blood, may appear in the urine." 
7 



B.MM 98 HJEM 

Clinical Import The presence of hematogiobulin in the urine, indicates an 
excessive decomposition of blood globules, due to one of two causes: — 1st. The 
cause of the blood decomposition is temporary, the destruction being limited 
to a greater or smaller quantity of blood corpuscles ; the prognosis is favor- 
able. — 2. The cause of the decompositon is permanent; there is then produced 
a real dissolution of the blood, endangering life, and the prognosis is unfavor- 
able or doubtful.— From the observations of Meckel, Heschl, Frerichs, and 
especially from the excellent investigations of J. Planer, we learn that in 
certain cases, and very probably when a great quantity of hematogiobulin is 
set free, a granular pigment may accumulate in the blood, and, by obstruct- 
ing the capillary blood vessels, especially those of the brain, occasion serious 
consequences. It appears advisable, therefore, before giving a prognosis in 
these cases, to examine the blood under the microscope, to ascertain whether it 
contains any such granular pigment. M. Gubler has based his hypothesis 
of hemapheic icterus, upon the rapid and abnormal destruction of the corpus- 
cles, with accumulation of coloring matter in the blood. See Blood in Urine. 
Microspectroscopy. Urohematin. 

Haematoidin. Small rhomboidal prismatic crystals found in the decom- 
posed blood of ligatured blood vessels, and in that of extravasations ; they 
are the last product of decomposed blood, are red or yellow, insoluble in 
water, alcohol, ether, acetic acid, glycerin, dilute mineral acids, and dilute 
alkalies. They are derived from hematin. By some erroneously considered 
the same as hematocrystallin. 

Hematuria. The discharge of blood by urine ; the red corpuscles being 
present in their natural form. See Table, p 250. 

Hsemin. Crystals that may be obtained from fresh, putrid, or dried blood, 
and even from the oldest blood stains, and hence of value only as a test for 
blood. To procure them, separate the stain (from a supposed blood stain), 
place it in a test tube, add a drop or two (or more, according to amount of 
stain) of glacial acetic acid to it, boil it for a few seconds, filter a drop upon 
a glass slide, add another drop of acid, and set aside in a warm place to 
evaporate. They crystallize in rhomboidal tables of a blackish-brown, or, 
rarely light-brown color, and dissolve in caustic potassa. — Erdman macerates 
the suspected stain in water, and slowly evaporates the solution on a glass 
slide ; a minute crystal of common salt and a drop of glacial acetic acid are then 
added to it, and again gently evaporated to dryness over a spirit lamp ; when 
cool, a drop of the acid is again added, and under the microscope, if the stains 
were of blood, will be seen hemin crystals, in the drop of acid. They vary 
from yellow to red according to their thickness, and are soluble in caustic 
potassa. 

Hsemochromogene. A provisory name given by Hoppe-Seyler to a sub- 
stance intermediary between hematogiobulin and hematin, and found during 
the decomposition of the former. Its color is red purple. The existence of 
this substance has not been satisfactorily investigated; probably it is identi- 
cal with the coloring matter in urine, the urochrome, of Thudicum. Hemo- 



HEA 99 HIP 

chromogene is formed by the action of alkalis or acids on hematoglobin, when 
protected from the air; under the action of the air, hematin, and not heino- 
chromogene is the result of the decomposition. 

Heat. Heat applied to urine in a test tube, causes a precipitate of phos- 
phates, or of albumen; if the former, the addition of a little nitric dissolves it; 
if the latter, it is not dissolved. If a precipitate is already formed in the 
urine, and is dissolved when this fluid is heated, it is formed of urates; if the 
precipitate does not become dissolved, and the addition of acetic acid causes 
it to disappear, it consists of phosphates; or, if the acid fails to dissolve it, 
cystine or oxalate of lime may be present. The addition of nitric acid, instead 
of acetic, will cause a disappearance of the precipitate, if it consists of phos- 
pheites, or oxalate of lime crystals, while cystine remains intact. If caustic 
potassa be added to the urine containing a precipitate, and on heating it, 
ammonia is disengaged, the precipitate may consist of ammonio-magnesian 
phosphates. 

Hippurla. Urine containing an excess of hippuric acid. 

Hippuric Acid. Traces of this acid exist in normal urine, in the form 
of alkaline hippurates. But it is sometimes met with uncombined in the 
deposit of a urine, and can be detected and recognized under the microscope. 
Certain articles of vegetable diet, as apples, prunes, mulberries, cloudberries, 
cowberries, etc., as well as Peru and Tolu balsams, quinic, benzoic, and cinna- 
mic acids, give rise to it in human urine. It may also be found during a 
milk diet, and in the urine of diabetic patients, according to the following 
process of M. leery: — Precipitate the uric acid by hydrochloric acid, and 
examine the precipitate obtained under the microscope; if hippuric acid be 
present, long colorless prisms with four surfaces will be seen, which may be 
tested by the reactions hereafter named. If ten grains of benzoic acid be 
administered to a person on going to bed, hippuric acid will be found in the 
next morning's urine. This acid exists in large amount in the urine of her- 
bivorous animals. Fresh urine must be taken, because, under the influence 
of putrefaction it becomes converted into benzoic acid. It may readily be 
procured for examination in the urine of the horse or cow. There is nothing 
positively known regarding the clinical importance of this acid in the urine. 
It proceeds, in part at least, from metamorphosis of the nitrogenized sub- 
stances of the body. 

Urine containing hippuric acid is neutral, feebly acid, or alkaline, of sp. 
gr. 1.006 to 1.008, having an odor like whey, and often containing ammonio- 
magnesian phosphate. This acid can be obtained by evaporating the urine 
containing it to a few drops, then adding about half the bulk of hydrochloric 
acid, boiling the deposit that occurs in a few hours, in alcohol, then filtering, 
and evaporating. Hippuric acid is yellowish when mixed with animal sub- 
stance, but when perfectly pure, is colorless. It is soluble in ether, from 
which it is precipitated in needle-like crystals or prisms by evaporation; 
more soluble in alcohol, and less soluble in cold than in hot water. Its solu- 
tions redden litmus paper. It is soluble in warm nitric acid, and in hot 



HUS 



100 



HUS 



sulphuric and hydrochloric acids, from which it crystallizes on cooling; but 
if these acid solutions be boiled for a time, on cooling benzoic acid is formed 
in crystals, and glycocoll remains in the solution. A strong heat fuses it into 
a red oily substance having the odor of Tonka beans, at the same time decom- 
posing it into benzoic acid and benzoate of ammonia; at a higher heat it 
evolves an intense hydrocyanic acid odor, and leaves a porous, combustible, 
coaly mass. — It may be distinguished from ammonio-magnesian phosphates 
by adding a drop of acetic acid to the drop of sediment on a glass slide, 
which dissolves the phosphates, and leaves the hippuric. acid crystals intact. 
— It may be determined from uric acid (sometimes the needles of hippuric 
acid are fixed like spears on the larger crystals of uric acid), by collecting 

the sediment on a filter, 
Fig. 18. boiling a small portion of it 

in alcohol, which dissolves 
only the hippuric acid. 
Upon allowing a drop of 
this alcoholic solution to 
evaporate on a glass slide, 
crystals of hippuric acid 
will be obtained, and which 
may be further distinguished 
from uric acid by not giving 
the murexide reaction. 

Microscopical Characters. — 
Hippuric acid crystallizes 
in the form of rhomboidal 
prisms, which are long, glis- 
tening, transparent, four- 
sided, parallel to the longest 
axis, and the ends present- 
ing 2 or 4 bevelled surfaces ; 
sometimes they are in fine 
needles and scales. Their 
elementary form is always 
a right rhombic prism. 
They may sometimes be 
mistaken for crystals of 
uric acid, or of the triple 
phosphates. See Fig. 18. 
Hnsemann's Test. To a sample of the suspected urine add an equal 
volume of concentrated sulphuric, acid, and allow it to stand for 12 or 15 
hours at a temperature of 62° to 75° F.— or, still better, expose it for half an 
hour to a temperature of 212° F. On cooling, a faint violet-red color will 
be observed, if morphia or narcotina be present; a light red, if brucia; and a 
blue purple, if codeia. Now add a drop of nitric acid to the fluid (or one of 




A. 



Ordinary forms of hippuric acid, when benzoic acid 
is administered. 

Different forms of hippuric acid in healthy urine. 

Crystals of hippuric acid, by evaporation of an alco- 
holic solution. 

Crystals do., from an aqueous solution. 

Crystals do., after the action of hydrochloric acid 
on urine holding hippuric acid in abnormal pro- 
portion. 



HYD 101 HYD 

the following, chlorine water, chloride of iron, solution of chlorinated soda, 
or a small piece of nitrate or chlorate of potassa). A blue to violet red is 
soon produced, changing into a dark red if morphia be present; the same 
reaction if codeia. A bright pink red or carmine indicates narcotina. If the 
liquid contain brucia, it must be warmed, and chloride of tin be added to it, 
when a yellow color will gradually appear, which changes to an intense pur- 
ple on the addition of nitric acid. This test has been proposed chiefly for 
the detection of morphia, of which it will indicate the presence of one-hun- 
dredth of a milligramme. 

Hydra ted Deutoxide of Albumen. A modified albumen first obtained 
and described by Dr. JBence Jones. The urine gave no precipitate on boiling, 
nor with nitric acid; but when the urine became cool a precipitate occurred, 
which was immediately redissolved by heat. A similar substance occurs in 
the buffy coat of inflamed blood, in the secretion from the seminal vesicles, 
and in the albuminous fluid of pus. As this was found in a case of molli- 
ties ossium, Dr. Jones suggests examining for it again in similar cases; it 
might be detected by the addition of nitric acid to the urine, causing it to 
assume a red color. 

Hydrocblorate of Ammonia. Chloride of Ammonium. Amnionic, or 
Ammonium Chloride. This salt when taken internally passes out unchanged 
in the urine, though some observers have not been able to find it in this fluid. 
It is, like other chlorides, always in solution. It dissolves mucus, but does 
not coagulate albumen, and, according to Beale, its presence in saccharine 
urine prevents the precipitation of the suboxide of copper, when the copper 
tests are employed for the detection of sugar ; in these cases, a solution of 
potash caused an evolution of ammoniacal fumes and a precipitate of the 
suboxide. This salt can be detected in urine containing only one of the two 
urinary salts, viz., urate, or ammonio-magnesian phosphate, and whichever of 
these two salts is present must first be separated, that the hydrocblorate only 
may remain. This salt crystallizes in octohedrons, but in presence of urea it 
crystallizes in the regular system of the cubic type, and sometimes in elegant 
arborescent forms, with swollen extremities; the swollen extremity of each 
arborization distinguishing it from those of chloride of sodium, — though 
there may, probably, be a mixture of the two chlorides. But little is known 
concerning the part performed by this salt in the urine. To detect chloride 
of ammonium, Simon states that the following appears to be the most appro- 
priate method: — Evaporate the alcohol extract of urine, dissolve a portion 
of it in water, and add a solution of caustic baryta. If ammoniacal salts 
are present, a strong odor of ammonia will be developed. Neither pure 
urea, nor the nitrate, on being similarly treated, gives off this ammoniacal 
odor. But the detection of ammonia does not prove its existence in the urine 
as a chloride. See Ammonia. 

Hydrochloric Acid. This acid destroys calcareous substances, renders 
the margin of blood globules clear and distinct, also fibrin, which it causes 
at first to swell, and then dissolves it ; acid 1 part to 4 parts water. It also 



HYD 102 HYP 

dissolves cystine, phosphates, hippuric acid, and oxalate of lime, and precipi- 
tates albumen, and uric acid from its salts ; it also renders evident the 
contents of navicular and their disposition, causing them to become blue or 
green, and likewise arrests the movements of vegetable cells. A little water 
added to concentrated hydrochloric acid, sufficient to render it less fuming, 
dissolves the intercellular substance of the kidneys, and thus enables to 
readily separate the tubes ; this usually requires from 12 to 24 hours. — The 
same as nitric acid, hydrochloric acid vapors render ammoniacal vapors 
white. Hydrochloric acid should be used, under the ordinary microscope, as 
seldom as possible, because it very rapidly injures the metallic mounting of 
the objectives; and when it has been thus used, the examiner must not forget 
to immediately cleanse the objective with a piece of fine old linen, or soft 
chamois skin. With a chemical microscope, in which the stage and glass 
slide or vessel is above the objective, the danger from corrosion is consider- 
ably less. These remarks equally apply to all mineral and corrosive acids 
and vapors. It must be recollected that hydrochloric acid favors the acid 
fermentation of urine, and the development of certain kinds of microscopic 
vegetable organisms which act as yeast ceils on the urates, rapidly decom- 
posing them. Nitric acid entirely prevents this action. 

Standard Solution of Hydrochloric Acid. For the Determination of Lime. Take 
1 gramme of carbonate of soda, heat it to redness, allow it to cool, weigh it, 
and dissolve it in distilled water. Add a few drops of tincture of litmus to 
color the solution blue, heat the fluid to boiling to drive ofl' free carbonic 
acid, and, still keeping at boiling heat, add from a graduated pipette or 
burette, dilute hydrochloric acid, until the blue color has passed into a pale 
red, that does not disappear with continued boiling. Suppose that, by calcu- 
lation, we find that 1 litre of the dilute hydrochloric acid employed, corres- 
ponds with 41.6 grammes of carbonate of soda; then 457 c. c. of the acid will 
saturate exactly 18.9 grammes of carbonate of soda. Therefore, we measure 
off 457 c. c. of the dilute hydrochloric acid, and mix it with enough distilled 
water to make the whole measure exactly one litre, or 1,000 c. c. of standard 
solution. Of this solution 1 c. c. exactly neutralizes 10 milligrammes of lime. 
It will always be proper to ascertain the accuracy of the solution by one or 
two confirmatory testings with carbonate of soda. 

Hytlrothioii. Sulphureted Hydrogen. 

Hydrsaria. Urine deficient in solid matters. Diabetes. 

Hyperclilorosodie. An excess of chloride of sodium in the system. 

Myperuresis. Incontinence of urine. 

Hyperurorrhea. Increased flow of urine. Diabetes Insipidus. 

Hypoclilorosodie. An absence or great diminution of chloride of sodium 
in the system. 

Hypostasis. The spontaneous precipitation of sediment in urine. 

Hypoxaiitljim. Sarkine. Carnine. Hypoxanthin invariably accompanies 
xanthin in the organs and in urine, and is a lower oxidized product than 
xanthin or uric acid, though it never forms a spontaneous urinary deposit. 



IXC 103 INO 

Like xanthin, creatine, etc., it forms one of the intermediate steps in the 
regres-ive metamorphosis of azotized tissues. Scherer found it in the spleen, 
in the urine of leucocythemia, and in the heart, and other organs. It was 
named hypoxanthin from the fact of its containing one equivalent less of 
oxygen than xanthin, to which it bears a strong resemblance. Between the 
hypoxanthin derived from the organs, and that from the urine, there exists, 
according to Thudiaum, some differences in a few of their reactions, although 
alike in all other respects. As nothing is known of its indication when exist- 
ing in urine, a further reference to it is unnecessary. 



Incontinence of Urine. Enuresis. Incapability of retaining the urine, 
which flows out involuntarily. 
Indican. See Uroxanihin. 

Indigo. See Color of Urine. Uroglaucin. Urrhodin. 

Indigo-glucin. A saccharine substance separated from uroxanthin or 
indican when this is decomposed by mineral acids, in order to procure its 
blue and red pigments. This indigo-glucin is capable of reduction by oxide 
of copper, but has no action under the fermentation test. 

Indigose. See Uroxanthin. 

Infusoria. See Monad. Bodo. 

Inosite. Muscle Sugar. A hydrocarbon or un fermentable sugar found in 
muscle and flesh, corresponding with grape sugar, but containing 2 atoms 
more water when crystallized. It has not been detected in healthy urine, 
but has been in diabetic, and albuminuric. A similar substance was detected 
by Vohl, in the unripe beans of Phaseolus vulgaris, and which he named 
" phaseomannite." It may be obtained as follows : — To 30 or 60 grammes of 
diabetic urine add a saturated solution of the tribasic acetate of lead as long 
as a precipitate ensues. Filter the mixture, and wash the precipitate on the 
filter so long as any sugar passes, and to the clear fluid, which contains the 
inosite, add solution of basic acetate of lead which precipitates an insoluble 
lead compound of inosite. Let the fluid stand for 24 hours, filter, and wash 
with distilled water so long as any soluble matter is extracted. Mix the 
precipitate with 30 or 60 grammes of distilled water, and pass a current of 
sulphureted hydrogen through the mixture so long as an insoluble precipi- 
tate of sulphide of lead occurs, and filter. Evaporate the clear filtrate to 
nearly dryness, add a drop of nitric oxide of mercury, and apply heat ; if 
inosite be present the fluid assumes a fine rose color, — if ordinary urine be 
employed, in which inosite is rarely found, uric acid interferes with the test, 
and consequently the first precipitate must be made with saturated solution 
of neutral acetate of lead; as well as in albuminous urine, which, however, 
must first be deprived of its albumen by acetic acid and heat. Gallois. 2. 



INO 104 IOD 

Inosite may readily be detected by evaporating a few grammes of urine to a 
syrupy consistence, and then adding a few drops of nitrate of mercury ; if 
inosite be present a yellowish precipitate ensues which, on being gently 
heated, assumes a pink color. On cooling this color disappears, but reappears 
under heat. The nitrate of mercury is made by dissolving one part of mer- 
cury in two parts of nitric acid, and then adding one part of distilled water. 

Inosite forms in colorless, transparent, cauliflower-like crystals massed 
together in groups, which belong to the clinorhombic system; they appear as 
groups of fine needles, as stars, or fan-shaped; though sometimes they are 
found single, and 3 or 4 lines in length. Exposed to the air they lose their 
water of crystallization, and become dull and opaque on drying. Inosite has 
a sweet taste, is readily soluble in water, but insoluble in alcohol, or ether. 
Boiling alcohol dissolves it, but on cooling it crystallizes in small glistening 
particles. It fuses at 410° F., forming a clear liquid mass, which, if rapidly 
cooled, crystallizes in needles, but if cooled slowly hardens into a horny 
amorphous mass. It does not undergo vinous fermentation with yeast ; with 
putrid cheese it yields butyric and lactic acids It does not brown with pot- 
ash, nor reduce the oxide of copper, like grape sugar. If its solution is 
evaporated on a platinum spoon, with nitric acid, nearly to dryness, and the 
residue be treated with ammonia and a little chloride of calcium, and then 
cautiously evaporated to dryness, if even J milligramme of the inosite be 
present, a vivid rose-red color is produced. This reaction is not produced 
with cane, grape, or milk, sugar. — Inosite has been found in the urine of 
albuminuric, syphilitic, and diabetic patients, but its clinical importance has 
not been ascertained. Perfectly healthy urine does not contain it. Gallois, 
who has bestoAved much attention upon this subject, is of opinion that inosite 
in the urine may be the result of an incomplete performance of the gluco- 
genic function of the liver. 

Inosuria. The voiding of urine containing inosite. 

Iodine. Tincture (as well as solution) of iodine, in contact with starch 
gives an intense blue color. It indistinctly colors all organized elements, as, 
epithelia, leucocytes, urinary cylinders, etc., both cells and nuclei, a greenish- 
yellow, rendering the vibratile cilia of spermatozoids, epithelial cells, and 
infusoria more distinct under the microscope, at the same time arresting their 
movements; the vegetable elements, as, spores, and filaments of algse and 
fungi (leptothrix, etc.) have their contents colored brown by it, while the 
envelop is not affected. The tincture gives a yellow-brown color to pros- 
tatic nitrogenized concretions, as well as to most of the nitrogenized sub- 
stances termed, " albuminoids." — Solution of Iodine; Iodine Water, used in 
urinary investigations is of two strengths, viz.: — 1. Take of iodine 5 parts, 
iodide of potassium 15 parts, distilled water 3,000 parts (all by weight). Mix 
the last two and then add the first. Label, " Solution of Iodine for Coloring^ — 2 
Take of iodine 1 part, iodide of potassium 1 part, distilled water 50 parts ; 
mix. This iodine water enables us to detect a peculiar form of degeneration, 
amyloid infiltration, at the same time it allows us to verify the amyloid 



IRO 105 IRO 

bodies of the br^in, and to distinctly characterize starch grains derived from 
the vegetable kingdom. It forms a beautiful blue color with pure starch, 
guaiac resin, and the pollen of plants ; the color changes from violet to 
purplish when the starch is mixed, or altered by fermentation or heat. The 
presence of a carbonate, or of an alkali in a solution containing starch, 
entirely prevents the reaction of iodine, hence, we should be careful to acid- 
ulate the solution before submitting it to the reagent. 

When iodine is present in urine it may be detected by the following pro- 
cesses: — 1. To 5 grammes of the suspected urine, add from 2 to 5 drops of a 
mixture of pure nitric acid, of 36° (sp. gr. 1.32), and concentrated solution of 
hypochlorite of lime an equal part. If the urine is colorless, and contains 
iodine in some quantity, it will instantly assume a yellowish color, due to 
the iodine set free. If the amount be very minute, add 2 or 3 grammes of 
bisulphuret of carbon, and strongly shake the mixture, the fluid becomes 
turbid, red droplets collect on the walls of the tube, and finally fall and 
form a more or less thick layer on the bottom. The intensity of the color is 
proportioned to the quantity of iodine dissolved in the bisulphuret. Degau- 
quier. — 2. If the urine be alkaline, first neutralize it with sulphuric acid, and 
then add a solution of starch (or starch paper may be dipped into it). This 
effected, add chlorine water, drop by drop, when the blue color of the iodide 
of amylum formed, will become manifest. There is no necessity for adding 
the sulphuric acid unless the urine be alkaline ; yet, as urine is apt to possess 
certain organic elements that prevent the reaction existing between iodine 
and starch, and that even decompose the amylum iodide when once obtained 
from this reaction, it will generally be found better to disorganize these 
elements by the addition of nitric, or sulphuric acid, previous to the applica- 
tion of the test. If a solution of nitrate of silver be added, instead of the 
chlorine water, a yellowish-white precipitate of iodide of silver at once 
occurs. — Other tests might be named, but it is not necessary. — 3. Prof. Bienzi 
uses the following reagent : 1 gramme of bichloride of mercury is dissolved 
in 30 grammes of distilled water ; to this a solution of iodide of potassium 
is added in sufficient quantity to redissolve the precipitate formed. Five 
drops of this mixture will detect infinitessimal traces 1 of quinia in half a 
cubic centimetre of urine two hours after 50 centigrammes have been taken 
internally. The addition of 5 drops of sulphuric acid to the urine will reveal 
the presence of quinia an hour and a half after 15 centigrammes of the alka- 
loid have been taken. We can thus determine whether the patient is still 
under the influence of this medicine. See Bromine and Iodine in Urine. 

Iron. Iron is a constituent of urohematin, one of the coloring matters 
of urine, and, if a large amount of healthy urine be acted on, more or less 
iron (traces) may be detected. Thus, take one or two litres of normal urine, 
and evaporate to dryness ; continue the heat until the whole is reduced to 
an ash. Dissolve the ash in a little very pure hydrochloric acid, triturate it 
in a glass or porcelain mortar, and after 15 or 20 minutes, add half its vol- 
ume of distilled water, boil for a few seconds, filter, and divide the filtered 



IRO 106 IRO 

solution into two portions. To one portion add a drop or two of nitric acid, 
boil, and add, drop by drop, sulphocyanide of potassium (1 part dissolved in 
10 parts of distilled water), according to the quantity of iron present, the 
fluid will assume a scarcely observable reddish tint to a deep red. — To the 
second portion, add a drop of nitric acid, boil, dilute with a little water, and 
add, drop by drop, ferrocyanide of potassium (1 part to 10 of distilled water), 
according to the quantity of iron present, an immediate precipitation of 
Prussian blue will occur, or blue flakes or light clouds of this blue will be- 
come visible in from one to several hours. This last, part of the process 
requires neutralization of the fluid, previous to adding the ferrocyanide of 
potassium, by solution of carbonate of potassa, because acid liquors are very 
apt to color the ferrocyanide blue. — Unless the hydrochloric acid used in this 
operation be very pure, no satisfactory result will be obtained ; it is difficult 
to procure this acid free from iron, and the presence of this metal in it would 
render the operation useless. See Urohematin. 

Preparations of iron taken internally, greatly increase the amount of this 
metal in the urine, and may be detected by the ordinary tests for iron with 
the usual reagents; or, 10 c. c. of the urine may be evaporated, in a small 
porcelain capsule on a water bath, to dryness, and then gradually heated to 
redness. The matter swells up, disengages odorate products, and when all 
disengagement has ceased, there remains only a black coal, which should be 
allowed to cool in the capsule. With a small wooden or platinum spatula 
scrape the coal from the capsule, pour some chemically pure hydrochloric 
acid upon it, triturate with a small glass or porcelain pestle, and then allow 
it to rest for 10 or 12 minutes. Now add one-half its volume of distilled 
water, boil for a few seconds, constantly stirring, and then filter. Divide the 
filtered liquid into two portions, and proceed as in the method just named 
above. Iron, in considerable quantity, can be found in the urine, after the 
tartrate of iron, and other of its salts, have been taken for several successive 
days. We may, consequently, study comparatively the facility of absorption 
of the martial preparations. Many of them simply pass through the diges- 
tive tube and are passed with the feces; in such case, they will not be found 
in the urine, and it is very presumable that they do not enter the circulation. 
From thence may be comprehended the uselessness of prolonging a treatment 
which is often exceedingly inconvenient. On the contrary, if iron, in a 
greater amount than exists in the coloring matter, be detected in the urine, 
it renders it absolutely certain that the metal has been absorbed; and when 
it ceases to manifest itself under the ordinary reactions, it is because it is no 
longer absorbed. 

Quantitative Analysis. — Evaporate in a platinum vessel, 100 c. c. of urine, 
and heat to perfect carbonization ; burn this until the whole of the carbon is 
driven off and a perfectly white residue remains. When cool, dissolve the 
mass in very pure hydrochloric acid, and heat it ; add water to it, and a little, 
q. s. sulphite of soda, and boil until the fluid becomes colorless, and no trace 
of sulphurous acid can be detected in it. Carefully pour into a clean flask, 



ISC 107 KID 

and add enough distilled water to bring the solution to about 60 c. c. in 
quantity. When thoroughly cool, place the flask upon a sheet of white 
paper, and, from a graduated pipette, drop into it the standard solution of 
permanganate of potash, until the fluid assumes a pale rose-red color, when 
the process is terminated. Now, if 1 c. c. of the permanganate solution cor- 
responds with 0.0005 gramme of iron, and, in the preceding operation, but 3 
c. c. of it were employed to occasion the test color, the 100 c. c. of urine, from 
which the ash and its solution were obtained and prepared, will contain 
3X0.0005 gramme, equal to 0.0015 gramme of iron. This, multiplied by 
1.43, will give the corresponding quantity of peroxide, and, by 1.286, of pro- 
toxide. Should the red color occasioned by the last drop of permanganate 
solution disappear after a short time, no attention should be given to it, as it 
is due to changes not connected with the analysis. The sulphite of soda 
added to the solution, above described, is for the purpose of reducing the per- 
oxide of iron to the condition of suboxide or protoxide. 

Ischuria. Suppression of urine; also, an incapability of voiding it when 
contained in the bladder. 



J. 

Jamentous. A term applied to colored, turbid, sedimentary urine, of a 
strong, rank odor, like that from a beast. 



K. 

Kidney, Brignt's Disease of. See BrigMs Disease. 

Kidneys. These organs, in health, as well as disease, remove from the 
blood certain efl'ete matters, in the formation of which they have not the 
slightest influence, as, urea, urates, uric acid, oxalates, phosphates, sugar, etc., 
the presence of which elements in the urine, according to their character, 
quantity, and quality, indicate a normal or abnormal condition, not of the 
kidneys, but of the system generally, — a healthy or unhealthy state of the 
nutritive or disa^similative process. On the other hand, an actual disease of 
the kidneys may affect the general system in proportion to its capability of 
removing the effete matters, referred to, from the blood; of which matters, 
urea is considered the most important. Albumen in the urine, especially 
when renal tube casts are also present, indicates, in most instances, a more or 
less serious structural lesion of the kidneys themselves, and which may affect 
the character and quantity of the urine in various ways. In the examina- 
tion of this fluid, the modifications it may undergo from physiological influ- 
ences alone, the morbid conditions of the organism that may occasion an 
excess or diminution of its normal elements, or develop new, abnormal mat- 
ters in it, and the influences exerted upon the nature and amount of its 



KIE 108 KIE 

healthy and unhealthy constituents by renal lesions, should be constantly 
kept in mind. 

Kiestein. This is a name given by Nauche to a whitish, iridescent pelli- 
cle, often observed upon the surface of urine of pregnant women several 
hours, or even a day or two, after its discharge. The etymology of the word 
indicates the relation that was supposed to exist between pregnancy and the 
appearance of this albuminoid pellicle ; a relation that is by no means con- 
stant. Indeed, this pellicle manifests itself upon the urine of non-pregnant 
women, as well as upon that of man, whenever the urine commences to 
putrefy and become ammoniacal. An entirely analogous phenomenon is 
produced upon fluids in which exist decomposing animal or vegetable sub- 
stances. Numerous observations have been made on this subject, with the 
following result: — In water in which bones are macerated, a peculiar tur- 
bidity will be observed, which is determined by the development in the liquid 
of various infusoria, and minute vegetable cells, cells of Protococcus, and 
which are endowed with extremely rapid movements. After a day or two, 
the fluid becomes covered with greenish patches, consisting of these same 
cells, agglomerated, immovable, and increased in size; if a drop of the liquid 
be taken, a little deeply, with a pipette, and be examined under the micro- 
scope, the green cells will be found still in motion, and will, at a later period, 
ascend and join those at the surface, thus enlarging the green pellicle, which 
will soon cover the entire surface of the fluid. At the same time, some of 
these cells will implant themselves upon the bones, and there develop them- 
selves. — A similar order of action occurs in vegetable infusions. If water, 
in which a bouquet, for instance, has been steeped, be exposed to the air, 
this water soon evolves a disagreeable odor, and, if a drop of it be ex- 
amined under the microscope, thousands of bacteriform infusoria, and vol- 
voces in quantity, will be found swarming and moving about in the fluid 
.drop. Several hours or days afterwards, according to the temperature and 
various other circumstances, a whitish pellicle will be formed, in which 
the previously moving bodies will be observed, immovable, and more or less 
deformed; they are the cadavers of our infusoria of the previous examination. 

Now, this is exactly what occurs in urine, which likewise contains nitro- 
genous matters, and which, sooner or later, undergoes putrid fermentation. 
Solely because the urine contains more crystallizable salts, will the pellicle 
be incrusted with them, and so thoroughly that after a short time it will 
break and settle to the bottom of the vessel, being carried down by the crys- 
tals. Then it will be replaced by another pellicle, which will be destroyed in 
the same manner. The fragments of the pellicle become mixed wilh the 
somewhat old sediments, thus rendering it somewhat difficult to draw them 
up with a pipette. Any one can ascertain the correctness of these statements 
by alloAving urine to pass into putrefaction, and carefully examining the 
changes that occur. — Kiestein consists of vibrios, spores, epithelial debris, 
crystals of urates, amorphous phosphate of lime, crystallized ammonio-mag- 
nesian phosphates, fatty particles, etc., and is simply an epiphenomenon of 



KLE 109 LAC 

the putrefaction of urine, supervening more or less rapidly. Prof. Kegnault 
believes that the production of kiestein, with pregnant women, is due to an 
excess of nitrogenous materials in the urine. This will explain the more 
rapid fermentation of the pellicle during the state of pregnancy. But this 
pellicle has no semeiological signification; it has been observed among 
anemic, scrofulous, and other patients, shortly after the emission of urine. 
Of course, the condition of the atmosphere and its temperature have a con- 
troling influence in the production of kiestein. 

Kletinsky's Cupro-potassic Test. For Sugar. Take of pure solid 
caustic potassa 4 parts, glycerin 3 parts, saturated solution of sulphate of 
copper 2 parts; mix. Boil in a test tube with the urine, if glucose be present, 
a reddish-fawn color will be produced. The sugar removes one equivalent 
of oxygen from the deutoxide of copper, and precipitates the red-fawn col- 
ored protoxide. Although this is a very delicate test, from the fact that 
crystallization of sulphate of potassa from the solution is unavoidable, thus 
preventing its being at once prepared for quantitative purposes, it presents 
disadvantages exceeding the advantages. 

Knapp's Test. For Sugar. This test is an application of the fact first 
observed by Liebig, that an alkaline solution of cyanide of mercury is com- 
pletely reduced by glucose to metallic mercury. This test is proposed as 
superior to Fehling's, as the test liquid is easily prepared and is absolutely 
permanent, the application is quicker, the results are accurate, and less time 
is required. Take of pure dry cyanide of mercury 10 grammes, distilled 
water a sufficient quantity to dissolve it, then add to the liquid a solution of 
caustic soda, sp. gr. 1.45, 100 c. c, and dilute with distilled water to meas- 
ure one litre. 400 milligrammes of cyanide of mercury, in a boiling alkaline 
solution, is completely reduced by 100 milligrammes of desiccated glucose. 
40 c. c. of the alkaline solution of cyanide of mercury (equal to 400 milli- 
grammes of cyanide) are placed in a porcelain capsule and boiled ; while 
boiling, the urine is dropped in until all the mercury is reduced. The quan- 
tity of urine required for this reduction will correspond to 100 millgrammes of 
glucose. In order to know when the mercury is completely reduced, as the 
urine is carefully added, a drop of the boiling liquid should from time to time 
be placed upon a clean piece of Swedish filtering paper, and be exposed to the 
action of a drop of diluted sulphuret of ammonia, or to a vapor from a 
concentrated solution of this sulphide ; when this procedure no longer de- 
velops a brown color the reduction is completed. 



L. 

tactic Acid has been found in some specimens of healthy urine, in small 
amount. This has been denied by Liebig, but other investigators have con- 
firmed the statement concerning its presence, under certain circumstances, 
advanced by Berzelius. To determine the presence of lactic acid in the urine 



LAT 110 LEP 

its zinc salt affords the most ready method: Evaporate fresh urine on a 
water bath to the consistence of thick syrup, and treat this with an alcoholic 
solution of oxalic acid. Oxalate of lime, soda, potassa, and urea are precip- 
itated, while there remains in the solution, phosphoric, hydrochloric, oxalic, 
and, if any be present, lactic, acids. The fluid is now digested with an excess 
of hydrated oxide of lead, and the precipitate of chloride, phosphate, oxalate, 
and the excess of the oxide of lead, separated by filtration. The filtrate con- 
taining lactate of lead, is treated with sulphureted hydrogen, and, after filtra- 
tion, is boiled with oxide of zinc ; again filtered, and allowed to stand until 
crystals of lactate of zinc form. The presence of lactic acid is readily deter- 
mined by the peculiar bellied, barreled, or club-shaped form of these crystals; 
and from them other salts may be prepared. Other processes have been 
given, but it is unnecessary to name them ; Lehmann, in his " Physiological 
Chemistry," Vol. I, has given a method by which lactate of lime is formed, 
being recognized by its double brush-like crystalline forms. The clinical sig- 
nification of lactic acid in urine has not been satisfactorily determined ; it 
may indicate a great supply of lactates to the blood, or, an acid fermentation 
occurring in the urinary passages. Lactic acid is said to be more or less con- 
stantly present in the urine of those who labor under pulmonary catarrhal 
affections, and in most febrile diseases, or where oxidation is effected imper- 
fectly. Lehmann found it always present in urine containing much oxalate 
of lime. 

L.ateritious. A term applied to the brick-dust like sediment of urine, as 
well as to the urine itself. 

Lead. Plumbum. In cases of lead poisoning, and the therapeutical use of 
lead preparations, this metal may pass into the urine ; though its detection 
is not always successful. Parke states that a peculiar yellowish color of the 
urine is sometimes observed. Ollivier advises the following process for its 
detection : — 500 or 600 grammes of the suspected urine is treated by nitric 
acid, then heated, and after addition of the same acid, is calcined. The resi- 
due is mixed with distilled water, left at rest for several hours, and is then 
thrown upon a double filter. Pour several drops of hydrosulphide of am- 
monium into the filtered liquid, until a precipitate is no longer formed; 
collect it upon a filter, wash, and dry it, — Again treat the dried precipitate 
with nitric acid and apply heat, which redissolves it The solution is then 
diluted with distilled water, filtered, the filtered liquid concentrated, and a 
little solution of iodide of potassium added to it. If a yellow precipitate 
falls we may rest assured that it is the iodide of lead, and this proof confirms 
the first determination by the hydrosulphide of ammonium. — For Reagents, 
see Acetate of Lead. 

L.eeks. Impart a garlicky odor to urine, when eaten in considerable 
amount, and also. increase the amount of oxalate of lime crystals. 

JLeptothrix Bnccalis. A microscopic, filamentous, chain-like, slowly 
moving, if at all, alga, observed in putrid or decomposing urine, and in the 
fluids of the mouth, and of which, bacteria and vibriones are supposed to be 



LEU 111 LEU 

various phases of development. Other allied species are also sometimes ob- 
served, as, leptomitus. See Algce- Vegetable Organisms. 

Leucin. Aposepklin. This substance is a normal product of some of the 
organs, as of the spleen, liver, pancreas, lungs, brain, etc.; that is, it has been 
met with in these organs alter death, but whether as a morbid product of 
decomposition, is not satisfactorily determined. It is likewise encountered 
in diseased conditions of these organs, in pus, thickened toe nails, perspira- 
tion of the feet and axillae, etc., being the result of decomposition ; with 
exception of that in the spleen. It appears, therefore, to be both a physio- 
logical and pathological element of various fluids and solids of the body, 
being frequently found in association with tyrosin. Leucin, as well as tyro- 
sin, belongs to the transition products in the metamorphosis of albuminous or 
nitrogenized substances. Dr. Harley considers them to be likewise the 
products either of the arrested, or of the retrograde, metamorphosis of glyco- 
cholic (crystallizable) and taurocholic (non-crystallizable) acids, and standing 
in the same relation to each other in disease as these two bile acids do in 
health. In urine containing leucin and tyrosin, there is always a decrease in 
the amount of urea. When leucin is present in urine, it may be detected by 
evaporating and concentrating the urine, and then examining a drop of it, 
when cool, under the microscope. Or, when present in minute quantity, 
it may be obtained by treating a large amount of fresh urine with solution 
of subacetate of lead, filtering to remove the precipitate formed, and then 
removing all traces of lead from the filtrate by sulphureted hydrogen. Again 
filter, evaporate the clear filtrate over a water bath to dryness; extract the 
residue with boiling alcohol, filter, and evaporate the filtrate over a water 
bath to the consistence of syrup. On standing for a day or so, tyrosin will 
crystallize in needles; at a later period, leucin will appear in yellow spheres. 
In this operation the urine must be used as soon as voided, because decom- 
posing animal matter 'Converts leucin into valerianic acid ; and if the urine 
be albuminous, before proceeding to the operation, it should be heated, and 
the coagulated albumen be removed by filtration. — It is unnecessary here to 
describe the methods for obtaining pure leucin, as it is almost invariably 
impure when obtained from urine. 

Microscopical Characters. Impure leucin, as first obtained from animal 
fluids, appears in yellow spheres or disks, with striae radiating from their 
centers, strongly reflecting light, and having a tendency to aggregate and 
form warty -like masses, the margins of the spheres in contact with each other 
appearing as if fused together. Sometimes they resemble oil globules, but 
these are more highly refracting, present a broader marginal outline, and are 
soluble in ether. Neubauer observes that the spheres of impure leucin are 
in part concentrically striped, and some of them finely pointed. These 
spheres may be determined from microscopic crystals of lime, by floating in 
water — the lime crystals sink. 

Chemical Characters. Impure leucin is partially soluble in water, less so in 
alcohol, and insoluble in ether. It is readily soluble in concentrated acids 



LEU 112 LEU 

and alkalis. Acetic acid renders it more soluble in water and alcohol. — Pure 
leucin is white (the yellow coloring of that found in urine being due to bile 
pigment), in crystalline scales, inodorous, tasteless, has a fatty feel to the 
fingers, and possesses the above named characters in great perfection. When 
cautiously heated to 338° F., in a glass tube open at both ends, it sublimes in 
thick flocculent fumes, without previous fusion, and which, like oxide of zinc, 
float along the tube and escape into the air. A solution of nitrate of mercury 
does not cause a precipitate in an absolutely pure solution of leucin, — any pre- 
cipitate thereby formed indicates the presence of tyrosin y that is, if the super- 
natant fluid has a reddish or a rosy-red color. Scherer gives the following test 
for leucin, pure, or even not quite pure: — Place a small quantity on a platinum 
spatula, add a little nitric acid, and carefully evaporate. A colorless and 
almost imperceptible residue remains. Treat this residue with a few drops 
of caustic soda solution, and apply heat, to dissolve the leucin, which, accord- 
ing to its purity, will form a transparent or yellow fluid. Concentrate this 
fluid over a spirit lamp, and in a short time it becomes converted into an oily- 
looking drop, which rolls about on the spatula, neither moistening nor ad- 
hering to it. However, enough leucin can rarely be had from a urine under 
investigation, to admit the application of this very characteristic test ; in 
such an investigation, we have to rely entirely upon its microscopic ap- 
pearances. 

Clinical Import. — Leucin has been occasionally met with in the urine of 
patients suffering from typhus, as well from small-pox. Its most important 
signification, however, is, in poisoning by phosphorous, and in that fatal 
hepatic malady termed "atrophy of the liver," — chiefly in its acute form, 
and frequently in the chronic, also in ramollissement of the liver. In the 
acute form of atrophy, leucin is usually in abundance in the urine. See 
Ty rosin. 

[Leucocytes. White Blood Corpuscles. Colorless nucleated blood corpus- 
cles observed in the blood, an increased development of which is present in 
that abnormal condition of the system termed " leucocythemia." It has been 
supposed that these white corpuscles were formed of chyle and lymph (the 
plastic element) previous to their being converted into red corpuscles (the 
respiratory element of the blood). The term leucocyte has also been proposed 
as a synonym for "sarcophyte" and "cytoid;" thus, leucocytes in mucus, 
mucus globules, or, in pus, pus globules, etc. The diameter of leucocytes 
varies from the -g-oVo^ 1 to tne T¥ff& tn °f an mcn m diameter. See Blood in 
Urine. — Since the employment of Hayem and Nachet's Hematimetre, in 
counting the red and white blood corpuscles, it has been observed by Malas- 
sez, Fouassier, Bonne, Brouardel, and other investigators, that the formation 
of pus in a focus always coincides with a great increase of leucocytes in the 
blood, which rapidly disappears after the opening, and evacuation of the 
contents, of this focus, — as, with all suppurative diseases. 

Clinical Import. — When leucocytes are observed in albuminous or purulent 
urine, no other element being present, they would lead to a suspicion of in- 



LIM 113 LIM 

flammation of some part of the urinary apparatus, as, cystitis, nephritis, 
pyelitis, etc. If they exist in non-albuininous urine, with epithelium and 
mucous casts, there is probably some irritation or diseased condition of that 
part of the urinary apparatus from which the epithelia are derived, with a 
morbid discharge of mucus. If they are but few in number, with crystals of 
ammonio-magnesian phosphate, the irritation or morbid condition is very 
probably confined to the bladder alone. See Mucus; Pus. 

Lime. Ca O. Calcium. Ca. Lime (calx) exists in urine in the form of 
carbonate, oxalate, phosphate, sulphate, and urate; more commonly as a phosphate. 
And in sections of country where limestone water, or water impregnated 
with lime, is used as a common drinking water, it is by no means rare to 
encounter oxalate of lime and phosphatic calculi. In cases so disposed to 
such calculi, it would be much better and safer to drink soft or rain water, or 
else distilled water flavored with toast, a little infusion of tea or coffee, some 
orange juice, or even a little wine, to render it more palatable. The use of 
water impregnated with lime, frequently interferes with the action of many 
therapeutical agents used in the treatment of diseases of the urinary appara- 
tus, and often those of the digestive. I am aware that these views are in 
non-accordance with those of several writers, I therefore give them simply as 
the results of my own investigations and experience in practice. 

In health about 120 to 200 milligrammes of lime pass with the urine 
voided in every 24 hours. To determine the presence of lime in urine, filter 
200 c. c. of the urine to be investigated into a beaker glass ; add ammonia 
until there is no longer any precipitate, and then carefully add acetic acid to 
dissolve this precipitate of earthy phosphates, adding a few drops of the acid 
in excess. To this solution add solution of oxalate of ammonia, and allow 
the glass, covered, to stand in a warm place until all the precipitate has sub- 
sided. Filter to separate the oxalate of lime precipitated, washing it well 
with distilled water, and preserve the filtrate and the washings for the deter- 
mination of the magnesia. 

The precipitate, together with the moist filter, is now placed upon a small 
platinum crucible, dried, and exposed to a strong red heat until all the car- 
bon is consumed. The lime residue, partly caustic, is introduced into a 
small flask (using a very little water, if necessary), to which 10 c. c. of the 
standard solution of hydrochloric acid are then added, and heat applied until it 
is all dissolved, and the carbonic acid be driven off. A few dro§s of tincture 
of litmus are then gradually added to color the solution light red; when the 
standard solution of soda is to be carefully added until the blue color returns. 
— Now, subtract from the 10 c. c. of hydrochloric acid which have been 
added, the number of c. c. of soda solution that have been employed, and 
we obtain the number of cubic centimetres neutralized by the lime, each c. c. 
of which corresponds with 10 mgrms. of lime. If 100 c. c. of urine have 
been used in the operation, by multiplying the number of c. c. of standard 
acid neutralized by the lime by 10, we directly obtain the percentage of lime 
contained in the urine. 
8 



LIN 114 MAG 

Bouchardat considers lime a good reagent for the detection of sugar in 
diabetic urine. He places 50 grammes of the urine in a beaker or matrass, 
adds to it 5 grammes of lime, and boils the mixture. The fluid assumes a 
caramel color, being darker in proportion to the quantity of sugar present. 
By this method he states that 5 grammes of sugar can readily be detected in 
a litre of urine. The reagent is made by slacking quicklime with water 
and then putting it into a bottle, corking it tightly. — When the above named 
boiling does not color the urine, 5 grammes more of the lime is to be added, 
and the whole again boiled ; if it does not then become colored, it only re- 
mains to be certain that the lime solution is good. For this purpose, throw into 
the urine in the matrass, a dessert spoonful of honey, or starch syrup, and 
boil. The urine must then become decidedly colored, which is evidence that 
the lime was well calcined in sufficient amount, and that before the last 
boiling, the urine contained no saccharine substance. 

Milk of Lime. This name is applied to a solution of lime in water, the 
lime being in excess so as to give a milky appearance to the fluid. It should 
always be thoroughly agitated previous to using it. — See Carbonate, Oxalate 
Phosphate, Sulphate, and Urate, of Lime. 

Iiineii. Linen fragments may fall into urine, and be mistaken for casts, 
etc. See Flax Fibres. 

Ijithate. Another term for urate. 

liitbia. Lithon. This is the oxide of lithium, Li, some of the salts of 
which have been used in medicine, as, the carbonate of lithia, which, from 
its soluble power upon uric acid and urates, has been found useful in calculi, 
in which these substances enter, as well as in cases where they form a greater 
or less amount of the deposit in urine. Bromide of lithia, useful in irrita- 
bility of the bladder, and in the neuroses. 

ILitliic Acid. Uric Acid. 

Iathodialysis. Litholysis. The dissolving of a bladder calculus. 

Iiittioaiepliritis. Nephritic calculus, in which the urine contains urate 
of ammonia, or uric acid, in form of small calculi or gravel. 

Lithos. A stone or calculus. 

Iiitboxiduria. Urine containing uric oxide. 

Iiitburia. Uric Acid Diathesis. That tendency of the system occasioning 
the deposition of uric acid and urates in the urine. 

IiOt. Lotium. Synonyms of urine. 



M. 

Magnesia. Magnesic or Magnesium Oxide. This is the oxide of magne- 
sium, Mg. It is met with in the form of carbonate in the urine of certain 
animals and in human calculi ; and almost invariably in the urine of man 
in combination with phosphoric acid, occasionally, with uric acid. For the 



MAT 115 MEL 

qualitative determination of magnesia, see Calculi, Analysis of; Carbonate of 
Magnesia; Amnion io-magnesian Phosphate, the presence of the crystals of 
which is evidence of the existence of magnesia in the urine. In health, from 
120 to 300 milligrammes of magnesia are passed by the urine in every 
2-4 hours. The quantitative determination of magnesia by the solution of 
perchloride of iron, is not a very accurate one; the determination of it as a 
pyrophosphate is the better process : Take the filtered liquor, that was pre- 
served during the operation for estimating the lime in urine after having 
separated the oxalate of lime (see Lime), and add ammonia to it until it has 
an alkaline reaction, and, if magnesia be present, there will be a precipitate 
of ammonio-phosphate of magnesia. After precipitation of these crystals has 
ceased, filter, and thoroughly wash the precipitate on the filter with distilled 
water to which a little ammonia has been added. Collect the precipitate in 
a platinum capsule, and expose it to a red heat; if any remains on the 
filter, burn this by itself and add the ash to that of the precipitate. (See 
Filter.) Now expose the whole to a red and white heat, which converts it 
into pyrophosphate of magnesia. The amount of this pyrophosphate, less 
the weight of the filter ash, multiplied by 0.3687, will give the amount of 
magnesia. See Carbonate, Phosphate, Urate, and Biurate Hydrate, of Magnesia; 
Ammonio-magnesian Phosphate. 

Matraciura. A urinal ; a vessel or flask for the reception of urine as it 
flows from the urethra, and of which there are several varieties. 

Maiula. Same as the preceding. 

t Maumene's Reagent, Cut woolen fabric, as merino, containing no 
cotton nor linen, into small strips, and soak them for 5 or 10 minutes in a 
solution of perchloride of tin 1 part, distilled water 2 parts. Dry the strips 
over the water bath, or in a drying oven. This is used for the detection of 
rather a strong proportion of sugar in the urine, by letting a drop of the 
suspected urine fall upon the wool thus prepared, drying it, and then expos- 
ing it to the dull red heat of an alcohol lamp, or in front of a hot fire. If 
sugar be present, a black spot is produced. This will detect l-20.000th of 
sugar. 

Melanin. Melanogene. Melanose. Block Pigmentary Matter. The name 
given to a solid organic substance characterized by its black or russet-brown 
color, and which exists as a pigmentary substance in many parts of the body, 
either in cells, or in the state of free granulations. It has also been met with 
in the urine in cases of melanotic cancer. When this substance is present in 
urine this fluid, frGm slow oxidation, gradually becomes of a dark color; but 
if an active oxidizing agent be added to it, as, chromate of potassa, sulphuric, 
nitric, or chromic acid, the freshly passed urine becomes instantly black. 
Upon being extracted, this substance forms a dark, coherent powder, soluble 
in concentrated alkalies, insoluble in water, concentrated acetic acid, and in 
nitric and hydrochloric acids, when these are sufficiently diluted not to de- 
compose it. Ammonia is its best solvent. Upon long standing, or on boil- 
ing, it communicates a dark color to water, and many other fluids in which 



MEL 116 MER 

it does not dissolve. It possesses neither taste nor odor, though when heated 
it exhales a disagreeable odor. It is composed of carbon, hydrogen, nitro- 
gen, oxygen, and less iron than exists in hematin. Melanin in the urine 
may aid in the diagnosis of obscure cases of melanotic cancer, when accom- 
panied by other corroborative circumstances and symptoms. However, we 
must be careful not to consider every ease of black urine as due to melanotic 
cancer, as it frequently accompanies other diseases, as, purpura, scorbutus, 
palustral poisoning, etc., and almost invariably is of an unfavorable signifi- 
cation, indicating a local disorganization of blood corpuscles in the kidney 
alone, or in the kidney and liver. Indeed, melanin, like the other coloring 
pigments of the urine, is derived from the coloring material of the blood, 
and, hence, may be present in urine, as one of the colors of urohematin. 
Albumen is frequently present in brown and black urine resulting from va- 
rious forms of disease, as, in jaundice, cardiac disease, etc. See Color of 
Urine. 

Melanourin. A name given by Braconnot to dark brown coloring matter 
in urine from which its cyanourine had been extracted. This urine was of a 
brownish yellow, but the color disappeared upon heating it, and a deep black 
sediment was deposited. In this urine, no uric acid was found. It is only 
one of the coloring matters derived from the blood, or from uroglaucin. See 
Color of Urine. Uroglaucin. 

Melanuria. Urine containing black coloring matter. See Color of Urine. 
Melanin. 

Melituria. Melithyperuria. Diabetes. Diabetic Urine. 

Mercury. Hydrargyrum. Mercury passes off largely by the kidneys, and 
may be detected in the urine for a long time after it has been taken. It does 
not appear to augment the amount of the urinary constituents in health. 
Thudicum states that when the urine contains mercury, a peculiar albumin- 
ous substance is present, as well as a substance giving the reaction of sugar; 
but, so far as I know, this condition has not been confirmed by other observ- 
ers. Mercury may be detected in the urine as follows: — 1. Strongly acidulate 
about 350 grammes of the urine with hydrochloric acid (about ^th its vol- 
ume), concentrate by evaporation to a small volume, filter, and then boil the 
filtered liquid with a small slip of bright copper wire or foil. — Even in very 
dilute solutions the copper becomes covered with a layer of mercury resem- 
bling silver; if the copper be washed, dried, and then heated in a small 
reduction tube, the mercury volatilizes, yielding a sublimate of metallic glob- 
ules, while the copper returns to its original red color. — M. Ludwig adopts a 
somewhat similar method; to half a litre of the urine he adds 2 or 3 cubic 
centimetres of hydrochloric acid warmed to 140° F., and then adds 5 grammes 
of granulated zinc, stirring briskly with a glass rod for a minute or so. The 
mercury amalgamates with the zinc, is precipitated, removed by filtration, 
washed with hot water, and dried in a water bath. Place the dried substance 
in a combustion tube drawn out at one end, heat it while a strong current of 
air is passed through the tube ; the mercury volatilizes, is collected in the 



MER 117 MER 

capillary portion of the tuhe, and, if allowed to come in contact with iodine 
vapor, gives fine ruby crystals of iodide of mercury. — 2. Since the researches 
of Merget upon the constant vaporization of mercury at the ordinary tem- 
perature, — researches carried on by means of extremely sensitive paper rea- 
gents, — we possess a means for readily determining the presence of traces of 
mercury. He impregnated paper with a solution of nitrate of silver in am- 
monia, which must be constantly kept in the dark. In contact with mercu- 
rial vapors, in the dark, this paper gradually gets darker and darker, until 
it becomes black from the reduction of the silver salt to the metallic state. — 
3. Attach a piece of platinum wire to a nail, immerse it in the suspected 
urine, and add pure sulphuric acid, until there becomes a gradual evolution 
of hydrogen gas. If mercury be present, it then becomes deposited upon the 
platinum wire in the metallic state. After a time remove the wire from the 
fluid, wash it with distilled water, and then expose it to the action of chlorine 
vapor, which converts the metallic mercury into the bichloride. Now, 
having ready prepared a strip of filter paper moistened with a 1 per cent, 
solution of iodide of potassium, rub this gently with the wire on which 
the bichloride remains, when a red color will be produced, the biniodide of 
mercury, and which color may be removed at once by applying an excess of 
iodide of potassium. Mayencon and Bergeret. 

4. M. Byasson, has proposed the following reagent, for the detection of 
mercury in urine : Take of bichloride of platinum 2, chloride of gold and 
sodium 3, distilled water 500 ; mix, and preserve in dark glass vials, as the 
salts in solution are reduced by direct light, diffused light, ammoniacal vapors 
and even by organic matters in the shape of dust. It would probably be as 
well to completely cover the vial with a black, varnished paper. To obtain 
the paper reagent, several lines are to be traced upon some white Berzelius 
paper (filtering paper), or other, by means of a goose-quill pen moistened 
with the solution, being careful to operate in a dark room, and to avoid 
touching, the lines made, with the fingers. Allow the lines to dry in a dark 
place,, as in a tightly closing drawer or box. The lines thus made, will, 
under the influence of traces of mercurial vapors, rapidly appear, and in 
from 20 to 30 minutes, assume a deep black tint. — The operation is as fol- 
lows : The bright copper foil having remained in the acidulated urine in 
which the presence of mercury is sought for (as referred to heretofore in 1), 
is taken out and washed with distilled water. It is then dried between folds 
of bibulous paper and introduced into the bottom of a new, or perfectly 
cleansed, test tube of copper. At the superior part of this tube, and without 
being in contact with the copper foil, are placed 2 or 3 pieces of the above- 
mentioned paper reagent ; the tube is then incompletely closed with a cork, 
and very gentle heat applied to its lower part. If mercury was present in the 
urine, in a few minutes the lines on the paper will appear of a yellow-brown 
color, soon becoming black. — M. Byasson recommends, as more sensitive than 
copper foil, the use of a Smithson's pile ; gold leaf rolled around a rod of tin. 
But, the gold leaf will require to be removed, or at least, calcined, for each 



MEE 



118 



MER 



Fig. 19. 



experiment. So that although the copper foil is less sensitive, it answers the 
purpose, and has the great advantage of being less expensive. And there is 
no reason why the copper test tube may not be replaced by one of colored 
glass, such as are now made, covered, if necessary, by copper foil, which, not 
undergoing directly the action of the mercurial vapors, may serve indefin- 
itely. — In using this test, we must be careful not to operate in a place where 
mercury exists in a free state, as, mercurial ointment, mercury jars, re- 
ceivers, etc. 

1. Standard Solution of Pernilrate of Mercury, Used vn the Determination of 
Chloride of Sodium. Take of perfectly pure mercury 17.06 grammes, put it 

into a beaker glass with pure nitric acid, and 
dissolve it in a sand bath, having the beaker 
covered with a large watch glass When 
fumes of nitrous acid cease to be evolved, and 
a drop of that fluid tested with chloride of 
sodium ceases to show any cloudiness from 
formation of subchloride of mercury, the solu- 
tion of oxide of mercury, thus obtained, may 
be evaporated in the beaker containing it, on 
a water bath, until it has a syrupy consistence ; 
then add distilled water sufficient to make the 
whole measure exactly a litre. Should the 
separation of basic salt render the solution 
turbid, it may at once be cleared up by the 
addition of a few drops of nitric acid. The 
next step is to graduate this solution — render 
it volumetrical. Having previously dissolved 
20 grammes of pure fused chloride of sodium 
in one litre of distilled water, and 4 grammes 
of pure urea in 100 c. c. of distilled water, we 
proceed as follows : Of the previously prepared 
chloride of sodium, measure 10 c. c. into a small 
beaker glass and then add to it 3 c. c. of the solution of urea, and 5 c. c. of a cold 
saturated solution of pure sulphate of soda. Next, fill a graduated pipette or 
burette with the above-mentioned solution of mercury, and let it fall into the 
mixture in the beaker glass, drop by drop, constantly agitating it with a glass 
rod, until a distinct and permanent precipitate or opalescence occurs, when 
the test is complete. — If 7.8 c. c. of the mercury solution only have been used to 
effect this precipitate, it is too concentrated to give accurate results, and con- 
sequently should be diluted with an equal volume of distilled water. If 1 5 c. c. 
of this diluted mercurial solution are required to produce the desired cloudiness 
in the above mixture in the beaker glass, we must add to every 155 c. c, of the 
solution of mercury, 45 c. c. of distilled water. By this means, a solution of 
pernitrate of mercury is obtained, of which 20 c. c. indicate 200 milligrammes 
of chloride of sodium, or, 1 c. c. of 10 milligrammes. In this process every 




Burette and Stand for Volumetric 
Analysis. 



MET 119 MIC 

drop let fall causes a white precipitate in the soda and urea solution, and 
which is redissolved by stirring the mixture, but, as soon as all the chloride 
of sodium is decomposed, and the insoluble precipitate of nitrate of mercury 
commences to form, the opalescence is not removed by stirring but remains 
permanent, when the process is finished. 

2. Standard Solution of Proto-nilrate of Mercury, Used in the Determination of 
Urea, by Liebig's process. — Take of dry, chemically pure oxide of mercury 
[sufficiently pure to leave no visible residue when volatilized on a platinum 
capsule], 77.2 grammes, place it in a porcelain basin, and by means of a 
gentle heat dissolve it in the smallest possible quantity of chemically pure 
nitric acid. When the solution is effected, carefully evaporate to the consist- 
ence of syrup. Remove from the heat and add distilled water enough to 
make the whole measure exactly 1,000 c. c , or a litre. Should there be a 
precipitate of any basic salt, add a few drops more of nitric acid until it be- 
comes redissolved. Onec. c. of this solution precipitates 0.01 gramme of urea. 

Metiisemoglobuliu. Meihcemoglobin. This is an intermediate condition 
between hemoglobin and hematin, and may be observed when the former is 
subjected to the action of carbonic acid gas, when deprived of oxygen, or 
when it ceases to circulate, as, in extravasations of blood. In hemorrhages 
from large vessels the urine is brighter and contains more hemoglobin ; in 
hemorrhages from the capillary vessels, it is darker, of a brownish-red color, 
and contains more methemoglobin. The determination of this substance as 
being derived from blood, or, as being one of the steps in the progress of its 
dissolution, is the same as for hematin, hemin crystals. 

Microscope. At the present day the microscope forms an important and 
valuable instrument for the physician and student; and he who does not 
avail himself of its utility in the diagnosis and treatment of disease, especially 
when of an obscure or obstinate character, is greatly behind the present era 
of his profession. Indeed no practitioner, who is not conversant with the rev- 
elations made by this instrument concerning the structure of the various 
parts of the system in health, and the changes effected upon these structures 
by disease, can lay claim to the title of a " respectable physician." It has 
often occurred that during the initial stages of severe and fatal maladies, the 
microscope has afforded information which, even before any appreciable symp- 
toms had become developed, revealed to the practitioner the alarming condi- 
tion towards which the patient was more or less rapidly hastening, and thereby 
led him to adopt an efficacious course of treatment long before the pathologi- 
cal lesions had become serious or of a permanent nature. But the value of the 
microscope does not cease with medicine, it has proved of immense service in 
geology, botany, mineralogy, chemistry, and indeed in nearly every depart- 
ment of science, besides having proven exceedingly advantageous in the detec- 
tion of adulterations in food and drugs, as well as of filth and impurities. 
Unfortunately some have conceived the microscope to be a mysterious instru- 
ment, capable of being managed or understood only by certain particular 
persons ; this is a great mistake; the instrument is intended solely as an aid or 



MIC 



120 



MIC 



improvement to our sense of sight. 
Fig. 20. 



Objects which can be seen well by the 
naked eye, do not require 
its assistance, save for the 
investigation of their mi- 
nute structure ; but with 
those which are too small 
to be thus seen, the pow- 
er of vision is greatly aid- 
ed by its employment, and 
every individual possess- 
ed of sight can readily 
avail himself of such as- 
sistance. Parties with im- 
perfect vision employ len- 
ses or spectacles to im- 
prove this sense ; and the 
microscope, a combina- 
tion of lenses, improves 
the magnifying and de- 
fining powers of the eye, 
almost enabling it, as it 
were, to observe and scan 
the invisible. Many par- 
ties possessing a micro- 
scope, instead of perfect- 
ing themselves in its use 
and its revelations, allow 
it to remain peaceably in 
its case, until they are 
suddenly aroused to de- 
mand some information 
from it; a satisfactory re- 
sponse is not obtained, 
and the conviction is then 
had that the instrument is 
of no service. This al- 
most always happens with those who have not, by practice at leisure mo- 
ments, made themselves capable of interrogating it by proper management — 
a mortifying and painful acknowledgment ! And yet, no better results 
are obtained from the ophthalmoscope, the laryngoscope, or the aural mirror, 
instruments of undeniable ability, occupying definite places among our means 
of diagnosis, if, perchance, one has never learned their management. It 
does not require a person to be an eminent microscopist or an accomplished 
chemist, in order to be a successful diagnostician and therapeutist. 

A great obstacle to the more common use of the compound achromatic 




Students' Microscope. 



MIC 



121 



MIC 



microscope, heretofore, has been its expensiveness ; but excellent instruments 
are now made by our best opticians, termed " students' microscopes," which will 
accomplish all that a practitioner can desire. The value and usefulness of a 
microscope does not lie so much in the beauty or workmanship of its brass 
mountings and other metallic accompaniments, as in the quality of its object- 
ives and eye-glasses. However great may be the magnifying powers of a 
microscope, it is useless unless it likewise possesses penetrating and defining 
powers. And in the purchase of one of these instruments, the name of its 
manufacturer should always be learned, as our best opticians never permit 
poor or imperfect glasses to leave their workshops. 

In selecting an instrument the error is frequently made of purchasing a 
very complete and expensive one, in the hope that it may be more easy to 
manage, and will give superior results ; but the contrary more generally 
happens. For if an individual does not apply himself to regular histological 
researches, he will soon ascertain that he has needlessly expended several 
hundreds of dollars, unless, indeed, his pecuniary resources are large and 
abundant. Movable stages, condensers, extra rack movements, diaphragm 
holders, etc., are absolutely useless for daily and practical observations. It 
is at once more economical and more convenient to purchase a simple 
" students' microscope," the optical apparatus of which is unobjectionable ; 
to which may be added, from time to time, as may be desired, a micrometer 
eye-piece, of which we should calculate the value of each division for the' 
series of powers possessed by the microscope, and the figures indicating such 
values should be arranged in tabular form on a card, which should be kept 
suspended near the table at which we work. This will enable us at once 
to determine the dimensions of any microscopic element submitted to observa- 
tion. — The employment of the camera lucida, adapted to the microscope, 
enables us to draw that which we observe ; a sheet of strong and smooth 
paper, or Bristol paper, may be used, and 
the best pencils for this purpose are Fa- 
ber's (graphite of Siberia), No. 5, or H. 
Then a sketch may be made of all known 
or unknown bodies, and the action of 
reagents, acetic acid, alkalis, coloring 
agents, etc., noted down; and at a later 
period these indications, together with 
other information subsequently acquired, 
may enable us to correctly determine them. 
A single personal observation is a thou- 
sand times preferable to the most detailed 
descriptions, and multiplied drawings. 
Every compound microscope should be 
furnished with a camera lucida that in- 
vestigators may, in addition to what has 
already been stated, estimate the magnify- 



Fig. 21. 




Dissecting Microscope. 



MIC 122 MIC 

ing power of their lenses, as well as the diameters of objects under exam- 
ination. — A microscope giving magnifying powers of 100 and 300 diameters 
is suitable for the greater part of observations ; but where it can be afforded, 
powers of 100, 250 and 500 diameters are to be preferred. A good work 
should also be procured to serve as a guide in the management of the instru- 
ment, and in the microchemical manipulations. 

It has been frequently objected that the employment of the microscope in 
medical practice occasions a loss of time which is not sufficiently compensated 
by the results obtained. This inconvenience has been- greatly exaggerated, 
and is owing to want of skill, and often to an excess of care. Many suppose 
that after each and every observation, the instrument must be returned to its 
case, for fear that it may become injured. This manoeuvre, very annoying 
moreover and needless, requires, in fact, triple more time than would be 
necessary to make a genuine and simple examination. There should be no 
hesitation in dispensing with it. By leaving the instrument properly equipped 
before a window, upon a small table furnished with a drawer or two, and 
upon which is kept the ordinary reagents, a flask of distilled water, a drop 
pipette or two, several glass slides, a piece of soft old linen, and a pasteboard 
or bell-glass cover to protect the instrument from dust, there will be con- 
stantly on hand, — all that is necessary for a rapid observation. There is 
nothing to fear from this apparent abandon. Any dust on the lenses may 
be removed by means of a soft camel's hair pencil ; if they become spotted or 
finger-stained, they may be gently rubbed with a piece of moistened soft old 
kid glove or linen, and the use of a similar dry article to dry the surfaces. 
Mineral acids, the vapors of which rapidly attack the brass mountings, should 
not be kept near the instrument. Indeed, strong acids and alkalis, volatile 
caustic fluids, sulphureted hydrogen, and all agents that may injure the 
metallic portion of the instrument, or that may act upon the lead of the flint 
glass of the lenses, should be avoided as much as possible. And should a lens 
unfortunately come in contact with any such agents or their vapors, it should 
at once be dipped into distilled water. To a certain extent any injury to the 
metallic part, from the above causes, may be avoided by giving the brass, 
etc., one or two coats of a mixture of 1 part of paraffin dissolved in 4 parts 
of benzine ; and to protect the surface of the objective lens, a thin glass may 
be placed over it by means of a layer of the above mixture carefully applied 
upon the metal surrounding it. During cold and excessively damp weather 
the room containing the microscope should be kept heated to prevent moisture 
from forming, especially upon the lenses. Finally, a suggestion which may 
appear singular, but the propriety of which will be sooner or later appre- 
ciated, is, to prohibit the person who attends to the apartment from dusting 
or wiping the table and the microscope ; this is the only method of avoid- 
ing any clumsiness or excess of zeal that may soon place the instrument out 
of use. 

It has been frequently remarked that it is very unfortunate the physician 
can not, while making professional visits, have a microscope with him ; but 



MIC 123 MIC 

this is not our opinion. A practitioner can always very conveniently carry, 
in a small sample tube, the urine it is desired to submit to a microscopic 
examination. But portable microscopes are now manufactured, by means of 
which examinations may be made in the sick chamber ; and, if a physician's 
pecuniary condition will not permit him to possess one of these, he can find 
in nearly every philosophical instrument store a small instrument of very 
moderate price, known as the " Coddington Lens" {Fig. 1), by means of which 
the greater part of urinary sediments and crystals can be perfectly recog- 
nized ; while with the microscope at home, he can subsequently complete the 
investigation. With a little careful and attentive practice, a person will soon 
become thoroughly conversant with the management and employment of the 
microscope, as well as with its revelations. 

The best microscopic objectives of high powers have their chromatic and 
spherical aberrations so perfectly corrected, that the thinnest glass cover 
upon the object renders its image indistinct to view. To obviate this defect, 
they are furnished with a compensating arrangement, by means of which 
distinct images of objects examined may be seen, from uncovered to a cover- 
ing with quite a thick glass cover; some mark is generally made upon the 
objective indicating how the glass should be corrected for uncovered objects, 
and by turning a collar so that the graduated line is carried towards 'covered," 
the glass may be corrected for any thickness of thin glass cover, and which 
correction simply consists in bringing the anterior lenses closer to, or more 
distant from, the posterior combination, by means of the regulating collar. 
In adjusting the objective for a covered object, it must first be arranged for 
"uncovered," and then we carefully focus for as distinct a view of the image 
of the object as can be obtained ; this done, turn the regulating collar around 
until a view is had of dust that may have settled upon the upper surface of 
the thin glass cover. Now carefully focus for the object by means of the fine 
adjustment. Note what the graduation is on the collar of the objective and 
mark it on the slide for future use, as it will always be the same for the same 
objective and eye-piece. — The best microscope makers in this country, are, 
Chas. A. Spencer & Sons, Geneva, N. Y.; K. B. Tolles, Boston, Mass.; J. 
Grunow, New York city; Wm. Wales, Fort Lee, N. J.; J. Zentmayer, Phil- 
adelphia Pa. Among the best works on the use of the microscope may be 
named Beale, Carpenter; or, a very cheap and useful little work by W. L. 
Notcutt. 

Microcosmic Salt. Sal Microcosmicum. A triple salt obtained from the 
urine, composed of ammonia, soda, and phosphoric acid. See Phosphate of 
Soda, Seutral. 

Micro-spectroscopy. This refers to a mode of examination of substances 
too minute to be observed under an ordinary spectroscope; a microscope, as 
well as a spectroscope especially adapted for the purpose, are employed in 
combination. The Sorby-Browning micro-spectroscope is an ocular spectro- 
scope designed for use with a microsope, and is probably the best one now made. 
Among other valuable determinations, the micro-spectroscope enables us to 



MIC 124 MIC 

recognize the state of oxygenation of the blood, its richness in red corpuscles, 
and the presence of oxide of carbon in these corpuscles. The manner of 
using the instrument is as follows :— Place a glass slide upon which is a drop 
of blood, upon the stage of the microscope, and examine it, with any power 
whatever, in the usual manner. When a clear and distinct image of the 
blood corpuscles is obtained, remove the eye-glass and replace it with the 
ocular spectroscope. We now do not see the image of the blood elements, 
but a spectrum according to the condition of the blood, oxygenated or deox- 
genated, etc. 

Oxygenated hemoglobin furnishes a spectrum presenting two bands of absorp- 
tion in the yellow-green part of the ordinary luminous spectrum ; the one to 
the left or yellow part being smaller than the one to the right or green part. 
To obtain these lines or bands the fluid examined must be properly diluted. 

Reduced or deoxygenated hemoglobin furnishes but one band of absorption, 
large and diffuse, and occupying the same part of the spectrum as the pre- 
ceding. The red of the spectrum is darker, and the blue clearer than is ob- 
served with the oxyhemoglobin. 

Oxygenated hematin furnishes one large black band on the limits of the red 
and yellow part of the spectrum, if it be acid ; and a larger band more to 
the right or yellow part of the spectrum, if it be alkaline. 

Reduced or deoxygenated hematin furnishes two bands, one, observed first, is 
large and intense, and located on the left in the yellow-green part of the 
spectrum ; the other does not appear until the first is completely formed, it 
is smaller and less distinct, and, if the quantity of blood employed in the 
experiment be too slight, it may be invisible, — it is situated on the right 
and in about the center of the green part of the spectrum. By agitating 
the solution in the air, these two bands disappear, and are not replaced by 
any others, unless hemoglobin is present. — In these experiments, as 100 parts 
of hemoglobin contain only 4 parts of hematin, we should experiment with 
concentrated solutions of hemoglobin. 

Methemoglobin, furnishes three bands of absorption similar to those of oxy- 
genated hemoglobin, and occupying exactly the same position in the spectrum, 
with the exception of the first band to the left being diffused and placed 
nearer the red of the spectrum ; the two rays in the green part of the spec- 
trum are fainter. 

Oxygenated Met hemoglobin differs from the above as follows : The band or 
line at the red of the spectrum disappears ; the two bands in the green become 
darker, and a faint band appears in the orange. On deoxydizing this solu- 
tion, we obtain the spectrum of oxygenated hemoglobin. — Sorby is probably 
correct, when he considers methemoglobin as a simple peculiar state of oxi- 
dation of hemoglobin. 

When the blood is poisoned by the oxide of carbon the hemoglobin assumes 
a blueish-red color. The spectrum is very analogous to that of oxygenized 
hemoglobin, the difference being that the two bands of absorption are placed a 
little nearer to the right or green part of the spectrum. The best characteristic 



MIC 125 MIC 

of the presence of this oxide is that its spectrum undergoes no change from 
the action of reducing agents, as hydrosulphate of ammonia, tartaric acid 
and protochloride of tin, ammoniacal solution of tartaric acid and sulphate 
of protoxide of iron, etc. 

The most important characteristic spectra of blood are given in the following 
table, together with the means for obtaining them, when the blood is under 
miero-spectroscopic examination. By pursuing these experiments according 
to the order indicated by the figures attached to the names, and to the exper- 
iments, even a novice may be enabled to make a successful examination. 

Table VIII. 

The substance to examine, blood, is recognized by the spectrum of : 

f Hemoglobin, 3. 
\ Methemoglobin, 9. 



i o i u.i • f Hemoglobin, 3. 

1. soluble in water,. 



2. Insoluble in water, but completely soluble in 

a weak solution of citric acid, or of ammo- 
nia, Hematin, 13. 

3. Add ammonia, double tartrate, and iron 

salt, Deoxidized Hemoglobin, 4. 

4. Stir, in the air, Oxygenated Hemoglobin, 5. 

5. Add citric acid, • Hematin, 6. 

6. Add ammonia, Oxygenated Hematin, 7. 

7. Addironsalt, , Deoxidized Hematin, 8. 

8. Stir thoroughly. Oxidized Hemoglobin. 

9. Add ammonia, Oxidized Methemoglobin, 10. 

10. Add double tartrate, and iron salt, Oxidized Hemoglobin, 11. 

11. Allow it to rest, Deoxidized Hemoglobin, 12. 

12. Stir in the air, Oxidized Hemoglobin. 

13. Add double tartrate.and iron salt, Deoxidized Hematin. 

The usual reagents in these investigations are, 1, a dilute solution of am- 
monia; 2, a dilute solution of citric acid; 3, double tartrate of potassa and 
soda in solution, employed to prevent the precipitation of the oxide of iron; 
4, solution of sulphate of protoxide of iron and ammonia, which serves to 
deoxidize ; 5, dilute hydrochloric acid ; 6, refined boracic acid ; 7, sulphite 
of soda ; 8, a small platinum wire to stir with ; 9, a glass cell slide to hold 
the fluid under examination. 

In all cases where the life of a human being may depend upon the result 
of the examination, it is always indispensable that the result be not recorded 
until it has been controlled by the superposition of the normal spectrum 
with that of the fluid under investigation ; this is readily effected with all 
good modern instruments, which are furnished with a special prism for this 
purpose. For further information the reader is referred to Proceedings of 
the Royal Society, Vol. XV, page 53, " On a Definite Method of Qualitative 
Analysis of Animal and Vegetable Coloring Matters," by H. C. Sorby ; also to a 
work entitled : " On Spectrum Analysis as Applied to Microscopic Observation" by 



MIC 126 MOR 

W. T. Suffolk, and sold only by John Browning, optician, No. 63 Strand, 
London, Eng. 

Mictio. Micturition. The act of voiding urine. 

Mitscherlitch's Saccharimeter. See Polarizing Apparatus. 

Monad. Naked bodies of roundish or oblong form, without any append- 
ages or variable expansions, having a single flagelliform filament, and a 
slightly vacillating motion. These corpuscles are very small, much smaller 
than a blood globule, being from T ^ooo tn to TsVo^ °f an " icn i* 1 diameter, 
and requiring a microscope of X500 in order to see them- accurately. They are 
colorless and transparent; their filament or cilium is difficult to perceive, and 
is frequently wanting. They are met with in al] fluids commencing to change, 
mingled with vibrios and bacteria. They are very abundant in urine con- 
taining a great amount of mucus and albumen, and may be observed shortly 
after its discharge; they also exist in the bladder of persons laboring under 
chronic cystitis. 

Morphia. This substance passes into the urine partly unchanged, whether 
it be derived from opium or from the morphia salts. It does not appear to 
have any important influence upon the water of the urine, the quantity of 
which is variable according to the temperature of the body and other circum- 
stances, though it diminishes the amount of urinary solids, especially the 
earthy phosphates. Micturition usually becomes less frequent, and the urine 
more highly colored, especially when the action of the skin is augmented, and 
there is apt to be a deposit of urates. It is very probable that morphia 
undergoes a partial or complete decomposition in the organism ; but when it 
is present in urine it may be detected by two or more of the following tests, 
first rendering 10 or 20 c. c. of the urine, pale, if required, by the addition of 
sufficient distilled water, and from which samples may be taken for testing : — 
1. To a small quantity of the diluted urine, slightly acidulated, add 2 or 3 drops 
of a solution of crystallized perchloride of iron 15 grains in distilled water 2 
drachms ; agitate, and then add 1 or 2 drops of a solution of red prussiate of po- 
tassium 1 grain in 2 drachms of distilled water. A light or deep blue color will 
at once appear, according to the amount of morphia present. Kalbruner. — 2. 
To a small quantity of the diluted urine, add a drop or two of pure hydro- 
chloric acid, and gently heat; then add a very small quantity of pure per- 
chlorate of potassium (entirely free from chlorate) ; the fluid immediately 
surrounding the perchlorate will at once assume a dark-brown color, if mor- 
phia be present, which will soon spread and extend. L. Siebold. — 3. A few 
drops of sulphomolybdate of ammonia produces, in a sample of the urine, a 
dark-red color, which, on standing, changes to purple, and finally dark blue. 
The test fluid is prepared by carefully heating 2 grains of molybdate of 
ammonia with 1 drachm of chemically pure sulphuric acid. This test should 
be prepared fresh as wanted. J. Buckingham. Froehde's reagent, of which 
the above is a modification, gives a violet color with morphia, and is consid- 
ered superior to Buckingham's; it is made of 1 part of sodium molybdate 
dissolved in 368 parts of pure concentrated sulphuric acid, and to be used 



MUC 127 MUC 

while fresh. Dragendorff found 1 part of the sodium salt to 1,840 parts of 
the acid, to be a still more reliable test. — 4. Add a drop or two of concentrated 
sulphuric acid to the diluted urine, and then a small quantity of oxide of 
cerium, on agitating the mixture an olive-brown color, becoming brown, will 
be produced. Sonneschein. — 5. Mix 3 drops of nitric acid of 1.25 sp. gr. with 
50 c. c of distilled water, and add 5 drops of this mixture to 10 grammes of 
pure concentrated sulphuric acid. Now to a sample of the urine add 2 or 3 
drops of pure concentrated sulphuric acid ; to the colorless solution add drop 
by drop, from 5 to 15 drops, as may be required, of the preceding solution of 
sulphuric acid mixed with nitric acid, and then 2 or 3 drops of water ; in 15 
or 30 minutes a violet-red color is produced. Upon adding a few small frag- 
ments of binoxide of manganese, or of chromate of potassa, an intense ma- 
hogany-brown color is produced. To this brown fluid add 4 times its volume 
of distilled water, and then render it almost neutral by addition of ammonia, 
a dirty-yellow color appears, changing to brownish red upon supersaturation 
with ammonia, without an appreciable precipitate. I. Erdmann- — 6. To the 
clear urine add iodic acid, and then a little of a mixture of bisulphide of 
carbon and chloroform ; a beautiful violet color appears. This will detect 
i(T?(i5 tn P ar t °- morphia. See Husemann's Test; Quinia. 

Mucin. Mwcosin. An albuminoid substance which is the principal organic 
constituent of mucus. It is entirely soluble in water in some instances, in 
others, it swells up; it does not coagulate by heat ; is precipitated by dilute, 
and redissolved by concentrated, acids. Alcohol separates it in flocculi or 
threads, which resume their original properties on being washed with water. 
When the mucous membrane is attacked with inflammation, an increase of 
mucin renders the discharge very tenacious. When mucus is very watery, 
its mucin is readily filtered ; Avhen it is very thick, the mucin almost entirely 
remains upon the filter. Mucin likewise appears to act differently with the 
same reagents, when the mucus, in which it enters, is collected from different 
mucous membranes. This substance may be readily studied in the white of 
egg. Mucin may be determined from fibrin, by the addition of dilute acetic 
acid, which causes the former to retract and present a very distinct striated 
appearance, becoming more and more concrete, while the latter, as well as 
its connectives, swell up, and take a homogeneous and gelatinous aspect, and 
are finally entirely dissolved. See Mucus. 

Haeo-pns. Muco-pus in urine is thready and gelatinous, from the action 
of carbonate of ammonia in this fluid. When this substance is from the 
mucous membrane, renal or vesical epithelia, dotted with fat, are present; 
when the pus proceeds from rupture of abscesses in the neighborhood of the 
urinary passages, these epithelia are absent, or very few in number. Alkaline 
urine dissolves the purulent globules. 

Mucus. All surfaces covered with epithelium give rise to a more or less 
fluid product, possessing the same general properties in all regions, and which 
is termed " mucus." It is to mucous surfaces what the furfuraceous des- 
quamation of the epidermis is to the cutaneous surface. Mucus is composed 



MUC 128 MUC 

of mucin, mineral salts in solution, especially chloride of sodium, car- 
bonated alkalies, phosphates, sulphates, etc., and certain principles of 
organic origin which may form, by precipitation, crystals, or amorphous 
grumous masses. Under the microscope may be seen (in mucus) epithelial 
cells, and debris of such cells, leucocytes, and droplets of fat. The cells and 
debris are characteristic of each mucus discharge, and aid us in determining 
the nature of the mucous membrane that has furnished this product. Leu- 
cocytes (mucous corpuscles) are identical in appearance, size, and anatomical 
characters, with the white blood globules, or with the elements of lymph and 
chyle ; they invariably exist in every mucus, but they may be very rare in it, 
and which is a sign that the mucous membrane is in a perfectly healthy 
condition ; and as this membrane becomes more and more irritated, so will 
the production of the leucocytes become more abundant; and thus we may 
observe all the transitions between physiological mucus and muco-pus, — a 
substance of a whitish appearance, containing an abundance of leucocytes, 
and which may at last undergo certain degenerations. The mucus of the 
several mucous membranes varies as to reaction, from some membranes 
giving an acid, and from others an alkaline, reaction. 

Normal urine presents only a few epithelial cells proceeding from the 
desquamation of the bladder, and of the urethral canal, some leucocytes, 
remarkable for their lack of dimensions relatively to the white globules 
found in other liquids, and traces of mucus in solution which give to the 
urine the property of frothing upon agitation. (But when the urine be- 
comes ammoniacal, from decomposition of urea, the leucocytes are more 
voluminous, turgescent, and swollen, the same as the leucocytes in buccal 
mucus.) In the normal state, the mucus is so mixed with the urine, as not 
to interfere with its transparency; but as it is not dissolved in this liquid it 
becomes soon deposited in or upon the urine as this fluid cools, forming a 
light cloud, enozorema, which holds some urates and epithelia in suspension, 
and it is so tenuous and swollen by the water of the urine, that, with acetic 
acid, it shows with difficulty the characteristic stria? of the mucin. The 
shining, varnish-like, sometimes scaly, layer, observed upon the dry filter, 
after having filtered urine, is its mucus. This mucus is normally secreted, 
but in very small amount, by the mucous membrane lining the urinary 
passages, and is carried off by the urine. And whenever it is present in 
abundance, quite visible, and very readily characterized, it indicates a patho- 
logical condition of the urinary passages. In health, from 4.50 to 1.95 
grammes of mucus are passed with the urine in 24 hours. — Mucus appears 
to be an important factor in the fermentative process of urine. 

Chemical Characters of Mucus. % The characteristic element of mucus is 
mucin. Dissolved in a fluid, it renders this viscous and thready, but it does 
not coagulate by heat, which distinguishes it from albuminous fluid. Mucin 
is precipitated from its solutions, by acetic acid, in the form of filamentous 
flakes, somewhat resembling coagulated fibrin, and which are insoluble in an 
excess of the acid. The addition of a solution of iodine and iodide of potas- 



MUC 



129 



MUC 



sium, renders these flakes or threads much more distinct. A solution of 
alum precipitates it, so do mineral acids, but the precipitate formed by the 
acids is readily resoluble in a slight excess of the acid ; if a concentrated acid 
is employed, the solution is effected at once without any precipitate. Basic 
acetate of lead and alcohol precipitate mucin in dense fibrous flakes. Alka- 
lies dissolve it. Hydrochloric acid dissolves mucus and clears up urine 
rendered turbid by its presence, when albumen is present. Dilute nitric acid 
dissolves mucus, thus distinguishing it from albumen. 

Microscopic Characters of Urinary Mucus. If, by means of a pipette, a small 
portion of the flocculent cloud held in suspension in the urine, be placed upon 
a glass slide, and then ex- 
amined under a microscope &' ^' 
of 450 or 500 diameters, leu- 
cocytes (mucous globules) 
will be observed, epithelia, 
some fatty droplets, and fine 
granulations of urates, the 
whole being included within 
an extremely pale substance, 
disposed in streaks, fre- 
quently anastomosed. If 
now, acetic acid be added, 
or, which is better, if a new 
drop of the mucus cloud be 
taken, and treated with a 
drop of acetic acid, and then 
be submitted to microscopic 
examination, the same ele- 
ments will be observed as at 
first, but modified. Two or 
three nuclei will be seen in 
the mucous globules (leuco- 
cytes), the epithelia will be 
paler and their nuclei will 
be more distinct ; finally, the 
pale substance will show itself fibrillary, or finely punctated. This latter 
substance is the mucus, the mucin of which has been precipitated by the acid. 
After a short time, small, square, or lozenge-like crystals of uric acid will 
appear, arranged in series along the filaments of the mucus. This reaction 
is important, as it enables us to determine fibrin from mucus, for, as already 
stated, an inverse action is effected upon fibrin by this acid, which renders it 
paler, less distinct, and eventually, by dissolving it, causes its disappearance. 

Mucus is slightly colored by solution of carmine, which should not be of 
too dark a color, nor contain any ammonia ; the advantage of this reagent is 
to render the epithelia and leucocytes more conspicuous. Vogel recommends 
9 




Mucus found in urine. 

Mucus, acted upon by acetic acid. 

Blood corpuscles, cohering. 

Blood corpuscles, separate. 

Oil globules. 

Epithelial cells of the urethra. 



MUC 130 MUC 

the tincture of iodine, which both precipitates and colors the mucus. — Beside 
urates, the mucus may hold crystals of oxalate of lime, or, of ammonio- 
magnesian phosphate. However, these are exceptional cases, and are only 
met with in certain pathological conditions, referred to under Clinical Import. 
— Nasal, or expectorated mucus, possesses the same characters as just de- 
scribed, but without the presence of any crystals. — It may be proper to state 
here, that C. Meliu has determined that the substance generally considered to 
be urinary mucus, is not mucus in reality since it contains no mucin, but is 
merely a normal or pathological urinary sediment consisting of epithelial or 
organic detritus, pus, sperm, phosphates, urates, etc.; and that its appearance 
varies with the elements composing it, and with the acidity or alkalinity of 
the urine. Query. Does urine exert a decomposing action upon mucin ? 

Clinical Import. When an abnormal amount of mucus exists in urine, it 
forms a more or less considerable glairy deposit, adhering to the bottom of 
the urinal, as, in vesical catarrh. But to be exact, it must be added that it is 
mixed with pus, rendered glairy by the action of the carbonate of ammonia, 
which is so rapidly produced in the urine of patients laboring under this 
affection. — Again, the presence of an abnormal amount of mucus in the 
urine, indicates, to the physician, the existence of a slight irritation at some 
point of the urinary mucous membrane, and which point may frequently be 
determined by the form of the accompanying epithelia. With females, this irri- 
tation may also be seated in the genital mucous membrane. At other times 
the excess of mucus is due to a general condition, as, fevers, typhus, pneumonia, 
etc. — Finally, there is a particular form of mucus in the urine, which should 
be described. We have encountered it very frequently, and have referred to 
it elsewhere. See Pus. This form presents more or less transparent, whitish 
filaments, which, with many persons, are voided with the first jet of urine. 
They are 1, 2,. or 3 centimetres long, and from x^th to T 3 oths millimetre 
thick, and when left at rest slowly fall to the bottom of the urinal. Beside, 
the microscope (at least 400 diameters), shows smaller ones, invisible to the 
naked eye, and almost imperceptible in the deposit, or in the nubecula of 
normal urine. They may likewise be found in various morbid deposits. 
They consist of a quite firm microscopic filament of mucus, gradually swell- 
ing in the urine, ordinarily striated lengthwise, sometimes with no striae or 
hardly visible, but becoming manifest on contact with acetic acid. This mu- 
cus includes within it fine granulations; more or less deformed and elongated 
•leucocytes, recognizable under the action of acetic acid ; spherical leucocytes ; 
at times, pavement epithelial cells; and sometimes, with man, dead sperma- 
tozoids, or living, when the urine is fresh. These filaments are rectilinear or 
diversely flexuous, according to the fortuitous circumstances of the prepara- 
tion ; they contain leucocytes in variable quantity in different subjects, and 
even in the different filaments. These elements are more numerous among 
persons who have had gonorrhea, and the filaments are then whiter and more 
abundant. 

Authors have variously described these filaments, as being : — 1, casts from 



MUL 131 NES 

the renal tubes; 2, more frequently as coming from the prostatic canals; and, 
3, as coming from the testicular and epididymary tubes. But in the normal 
and even in the morbid state, none of these organs produce any mucus. On 
the contrary, it is certain that these filaments, simple or ramified, are formed 
from the mucus accumulated in the folds of the urethral mucous membrane, 
in which it includes leucocytes, epithelial cells, etc. In man, they are found 
especially in the folds of the sinus of the urethra (of Lecat, Fr.), at the junc- 
tion of the membranous and bulbar parts of the canal ; at this point they 
receive sperm atozoids which escape in small amount, normally and inde- 
pendently of any seminal loss, with individuals who, for any cause whatever, 
abstain from sexual contact for several weeks. The filaments formed in the 
period following coition also contain them. — The presence of these filaments 
with leucocytes in the urine of women, in the unimpregnated as well as in 
the impregnated condition, shows that they do not come from the prostatic 
nor the seminal tubes. 

Mulberry Calculus. Mural. Names given to the rough oxalate of lime 
calculi, having tuberculated surfaces, resembling those of mulberries. 

Mulder's Test. For Grape Sugar. Place a little pure sulphate of indigo 
in a test tube, add the urine to be tested, and boil the mixture. Add to it a 
solution of carbonate of potassa or of soda; if glucose be present the mixture 
becomes decolorized ; if not, it remains blue. This determines the presence 
of a very minute quantity of sugar ; and if traces of it only be present, a very 
small amount of the indigo salt should be added to the urine. The solution 
of soda has to be in excess, so as to render the indigo alkaline. 

Mnrexide Test. See Purpurate of Ammonia. Uramile. 

Muriate of Ammonia. See Hydrochlorate of Ammonia. 

Mycouerma Cerevisa. See Torula C. 



N. 

Nepheloid. Nebulous, or cloudy. 

Nephranuria. A non-secretion, or very diminished secretion, of urine by 
the kidneys. Renal ischuria. 

Nephritic. Of, or belonging to, the kidney. 

Nephritis. Inflammation of the kidney, of which there are several 
varieties. 

Nepbrochalazosis. A name for Bright's disease. 

Nephroptosis. Renal suppuration. 

Nessler's Test for Ammonia. To 10 or 15 drops of a cold concentrated 
solution of chloride of mercury, add solution of iodide of potassium (7 Tr. 
grains to 6 f£ distilled water), drop by drop, agitating the mixture bo as to 
dissolve the red precipitate of mercuric iodide as fast as it forms, and con- 
tinuing the operation until this precipitate is exactly dissolved, or, at least, 



NEU 132 NIC 

nntil a very minute amount of it remains undissolved. Filter. Then make 
the solution strongly alkaline with hydrate of potassa (20 Tr. grains caustic 
potassa to 10 13 distilled water), and add enough distilled water to make the 
whole measure 25 fluidrachms ; filter if necessary. 

If this solution (Hg I 2 2 K I + K) be added to water or diluted urine, 
containing .03 of a grain of ammonia to the gallon, a yellow color will be 
produced ; a greater quantity of ammonia will give a brownish-yellow color, 
or a reddish-brown precipitate, supposed to be tetrahydrargyro-iodide of 
ammonium (N Hg 2 I). This is a very delicate test, interfered with, how- 
ever, by the presence of cyanide of potassium, or, of sulphide of potassium. 

Another method of using it is, to place the urine in one vessel, and imme- 
diately, above this, place another vessel containing a mixture of 1 part 
sulphuric acid and 9 parts distilled water. Now cover the whole with a bell 
glass. (An ordinary drying apparatus will answer for this purpose.) In 20 
or 24 hours add 1 drop of the mercurial solution to the acid fluid ; if it con- 
tains ammonia, absorbed from the ammoniacal vapor evolved from the urine, 
a precipitate will occur of a brownish tint. See Babuteau's Method. 

Neutral Urine. Urine which gives neither an acid nor an alkaline 
reaction is termed neutral. This is not owing to the positive loss of acid, but 
to its neutralization by bases, fixed or volatile alkalies. Even when voided 
acid, urine may become, in a short time after its discharge, neutral, or alka- 
line, from decomposition of its urea into ammonia and carbonic acid. But 
urine may be neutral when passed, and which may be due to decomposition 
of urea in the bladder, or to the use of certain agents, as, alkaline carbonates, 
carbonate of lime or magnesia, etc. In anemia there may be a diminution 
of the phosphoric or sulphuric acid of the urine. As neutral urine most 
commonly becomes alkaline in a short time, being as it Avere the first step 
towards alkalinity, in urinary investigations neutral and alkaline urine are 
considered as equivalents. See Alkaline Urine. Prof. Loreta, of Bologna, 
has related several instances in which concussion of the brain was followed 
by neutral urine during a period of from 8 to 24 hours after the shock ; M. 
Testi explains this by stating, that from the abatement of the velocity of the 
circulation, the phosphate of soda contained in the blood does not encounter 
uric acid in the kidney, hence this salt remains neutral instead of becoming 
acid, and the urine is thus left neutral. 

New Constituent of Urine. This was first separated from the urine of 
a dog, and finally from human urine, by F. Baumstark. It forms white, hip- 
puric acid-like columnar crystals, of the formula C 3 H 8 N 2 O, which are 
sparingly soluble in cold water, freely soluble in boiling water, insoluble in 
ether or absolute alcohol, and forms soluble salts with acids. Heated in a 
tube it evolves dense white vapors having the odor of ethylamin, and a com- 
bustible gas of an alkaline reaction. 

Niekel. A salt of nickel in solution is mixed with solution of acetate of 
soda, to which solution of hypochlorate of soda is added, and the whole 



NIT 133 NIT 

heated to the boiling point, a dark blue precipitate of peroxide of nickel 
occurs, which is soluble in nitric acid. 

Nitrate of Silver. Argentic, or Silver Nitrate. Indicates the presence of 
hydrochloric acid, whether free or combined, in the fluid under examination, 
by causing an instantaneous white cloud of chloride of silver, which precipi- 
tates in a caseous magma, and which, by exposure to the air, changes to a 
hyacinth, or more or less, violet color. Under the microscope the magma 
preserves its curdled form. This precipitate is insoluble in dilute nitric or 
hydrochloric acids; in the cold it is soluble in ammonia, and in very concen- 
trated hydrochloric acid by heat. Solution of nitrate of silver gives a yellow 
precipitate with phosphate of soda; a brick-red with arsenic acid; olive- 
brown with lime water or the fixed alkalies ; and yellow with the alkaline 
arsenites. Metallic copper or phosphorus added to a solution of nitrate of 
silver, occasions a precipitate of metallic silver. The yellow precipitate of 
tribasic phosphate of silver, formed when nitrate of silver is added to a phos- 
phate, is soluble in excess of ammonia, and in excess of nitric acid. In 
urinary investigations the argentic nitrate is employed for the detection of 
chlorides and phosphates. 

No. 1. Nitrate of Silver Solution. Take of nitrate of silver, in crystals, 1 
gramme, distilled water 10 grammes; mix. Preserve in a well stopped vial 
and label, " Solution of Nitrate of Silver at the j^th. For Detecting Chloride of 
Sodium." — No. 2. Nitrate of Silver Solution. Take of pure fused nitrate of 
silver 11 grms .63, distilled water 400 grammes; mix. Preserve in a well 
stopped vial, and label, "Solution of Nitrate of Silver. Exact Estimation of 
Chloride of Sodium. 1 c. c. of the Solution = 1 centigramme of Chloride of Soda" 
The purity of this reagent should be ascertained as follows: The solution 
must be perfectly neutral ; on precipitating a portion by hydrochloric acid 
and filtering, the filtered liquid should leave no residue when evaporated on 
a watch glass, and must neither be colored nor precipitated by hydrosulphuric 
acid. See Stains, etc. 

Xitrate of Urea. See Urea. 

Xitrie Acitl. Azotic Acid. This acid colors fresh albumen yellow, espe- 
cially when heated ; it also colors the albuminoid substances of animal 
tissues yellow, as, nails, horn, etc , often causing the outlines of the individual 
cells to become very distinct. When vapors of ammonia are evolved, by 
subjecting them to the action of the vapor from nitric acid they become 
white; this may be effected by holding a glass rod, moistened with the acid, 
near to the point "from which the ammoniacal evolution is occurring. Nitric 
acid dissolves cystine, oxalate of lime, urea, and triple phosphates, converts 
hippuric acid into benzoic, and precipitates albumen. The remarks concern- 
ing the care required in employing hydrochloric acid with the microscope, are 
equally applicable to nitric acid. Pure colorless nitric acid is used in urinary 
investigations; also, a SDlution of nitric acid 1 part, distilled water 10 parts. 
See Stains, etc. 

Kitroso-Xitric Aciti. Fuming Nitric Acid. This is a common commer- 



ODO 134 ODO 

cial acid containing nitric and nitrous acids with water, and is generally sold 
as nitrous acid. It fumes in the air, has a brown or yellowish-red color, and 
is more corrosive than concentrated nitric acid. Its formula has also been 
given as H N 3 -f N 2 £>4> being nitric acid containing tetroxide of nitrogen. 
It constitutes Gmelin's test for determining the presence of bile pigment in 
the urine. 



0. 

Odor of Urine. Odor is a characteristic reaction of certain bodies ; but 
it can not describe them, it can only compare them. The alliaceous odor 
denotes the presence of arsenic in an inorganic substance when thrown on 
burning charcoal. The odor of chlorine is characteristic, resembling some- 
what that of nitrous and sulphuric acids; in this case, practice alone will 
enable one to detect it. The odor of iodine is somewhat similar to that of 
saffron. Sulphuric acid, when heated, and simply mixed with water, evolves 
a distinct odor. Ammonia in a state of evolution is known by its odor, 
which is very similar to that of carbonate of ammonia; its vapor causes the 
tears to flow. It is similar with acetic acid. The addition of a drop of 
hydrochloric acid, gives an odor different from that of any animal or vegeta- 
ble; the most fetid are often made to assume a bouquet which approximates 
the odor of violets, apples, etc. The acid phosphates of ammonia give a very 
repulsive odor to the breath of certain persons. Nevertheless, the organs of 
smell and taste are two reagents whose indications vary according to the indi- 
viduals. On this account, every one should make from practice and memory 
a table of indications for his own use ; these reactions being, after all, only 
signs which we can not transmit positively to others, and which only serve to 
point out the method that led to the indication. 

The odor of healthy urine is characteristic, and of a peculiar kind, due to 
the presence of certain volatile acids, determined by Stadeler, as carbolic, 
taurylic, damaluric, and damolic, and it is so indestructible that an analyst 
can not remove it by any of the processes pursued in urinary investigation. 
When a mineral acid is added to urine, its odor becomes modified and 
stronger. The urinous odor may be produced by scorching a drop or two of 
urine on a piece of linen, or, by treating it with sulphuric acid ; by this 
method urine can be determined from any other fluid. The urine of animals 
varies in odor, each one having an odor characteristic of the animal, and 
usually smelling like the fat of the animal from which it is obtained. The 
strong urinous odor of concentrated urines is due to the presence of urea, and 
when this undergoes decomposition, an ammoniacal odor, more or less pun- 
gent, is emitted from the carbonate of ammonia formed, and, should the 
organic matters, as, mucus, etc., undergo decomposition at the same time, a 
putrid odor is also observed, and which is more common with urine during 



OIL 135 OXA 

some destructive renal or cystic malady, when the organic substances are in 
greater amount; if sulphur be formed during the process of decomposition, 
6ulphureted hydrogen may be emitted. If a fixed alkali be present the urine 
has a sweetish aromatic odor. Fresh diabetic urine has a sweetish or faint 
whey-like odor, which changes to that of sour milk on fermenting. Bloodj 
pus, or sanious discharges also give a stale, offensive odor, resembling that of 
tainted flesh. With these exceptions, the urine in all diseases, persistently 
retains its characteristic urinous odor, and hence, in a clinical point of view, 
the smell of the urine is of minor importance, being simply suggestive. 

However, many articles of diet, medicine, etc., communicate certain pecu- 
liar odors to the urine : As, asparagus, valerian, assafetida, castor, coffee, 
garlic, onions, turpentine, cubebs, copaiba, sandal-wood oil, saffron, etc. 
Turpentine imparts a violet odor, whether it be swallowed or inhaled. It 
has been stated that in gout, and in organic diseases of the kidneys, these 
odorous substances, when taken internally, especially asparagus, turpentine, 
etc., can not be recognized in the urine by their smell, but observations by 
Vogel and others have disproved this statement. 
Oil Globules. See Fatty Matters. 
Oliguresia. Oliguria. Want or deficiency of urine. 
Omichesis. Voiding urine. 
Omkhma. The urinary fluid. 
Onions. See Garlic. 

Organic Globules. Described by Dr. Golding Bird. The " large organic 
globules" have been observed in cases of ardor urinae, in the urine passed 
during the latter months of pregnancy, but more abundantly in confirmed 
cases of Bright's disease. They consist of a cell wall, containing more or less 
fat globules, diffused throughout a urine in which there is no albuminous or 
viscid element, as observed in urine containing pus or mucus. Acetic acid 
added to these globules, develops internal nuclei. They greatly resemble, 
what has been termed, " exudation cells," or " compound granular cells." 
The " small organic globules " differ from the preceding in not having a 
granular surface, and presenting no nuclei or granular structure, even under 
the action of acetic acid. They are not so commonly observed as the large 
variety, and are supposed to be the escaped nuclei of certain cells. See 
Fig. 30. 

Ourema. Ouron. Same as Omichma. 

Oxalate of Lime. Calcic or Calcium Oxalate. Urine may normally con- 
tain oxalate of lime, in a state of solution at the time of emission, and which 
in a few hours becomes deposited in crystalline form. It never exists in such 
quantity as to form a deposit by itself, but is found mixed with other salts, 
generally urates or uric acid; however, it is by no means uncommon to find 
it accompanied with an abnormal deposition of earthy phosphates, the urine, 
in 6uch cases, being either feebly acid at the time of its discharge, neutral, or 
alkaline. In these instances, the addition of acetic acid will dissolve the 
phosphates and leave the oxalate crystals intact. I will remark, however, 



OXA 



136 



OXA 



that in certain cases of hepatic and digestive derangement, and in a few cases 
of functional cardiac affections following sexual excesses, in which, during the 
flow of the last drops of urine, from half a teaspoonful to a teaspoonful of a 
white deposit was passed, I found this deposit to consist wholly of crystals of 
oxalate of lime. The urine was more generally that passed first in the morn- 
ing, and in several of these cases, physicians who had been previously con- 
sulted (without a microscopic examination), pronounced this white substance, 
semen. Whenever, a urine within 24 hours after its emission, deposits oxa- 
late of lime crystals, it is a certain indication of an unhealthy condition of 
the system, whether this be temporary or persistent. Two forms of crystals 
of oxalate of lime occur in urine, the octohedral, and the dumb bell, and either 
may be readily recognized under the microscope with a power of 350 or 400 
diameters. It is impossible to determine them by the naked eye ; the crystals 
may fall to the bottom of the tube containing the urine, or they may be 
entangled in the mucus flocculi and float in the liquid with it. The urine 
containing oxalate, is generally of decided acid reaction (rarely neutral or 
alkaline), of dark amber color, of sp. gr. 1.015 to 1.025, with a. greater or less 
abundance of epithelia; if the urine be greenish, the coloring matter of blood 
may be present. 

Microscopic Characters. Crystals of oxalate of lime formed in urine, are 

shining, well defined, per- 
ls'- 23. fectly transparent, square 
octohedra, having a strongly 
refractive power, and, when 
very regular, the intercross- 
ing of their axes gives to 
them somewhat the appear- 
ance of a letter envelop. 
They are generally very 
small; smaller than a leuco- 
cyte. However, some have 
been seen very regular, and 
having a diameter of 0mm 
.011 ; these being accompa- 
nied by a host of others of 
much smaller dimensions. 
Their small size permits 
then, a priori, of their separ- 
ation from certain crystals of 
ammonio-magnesian phos- 
phate which greatly resem- 
ble them in form, but are of 
larger size. Sometimes they 
present the appearance of a 
square, crossed obliquely by two bright lines ; and when exceedingly small 




A. Octohedral crystals of oxalate of lime. 

B. The same, when dry. 

C. Dodecahedral crystals of oxalate of lir 

D. Dumb-bells — oxalurate of lime. 

E. Oval forms of oxalurate of lime. 



OXA 137 OXA 

they look like dark squares having a transparent point in their center. Other 
more or less singular forms have been observed ; G. Bird has described some 
under the name of hour glass or dumb bell crystals, that resemble two kidneys 
united with their concavities opposite, or a bottle gourd ; these crystals are more 
frequently mingled with the octohedral, which will enable one to determine 
them from the dumbbells sometimes formed by urates, or uric acid. He has 
likewise observed oval grains, presenting a kind of nucleus, and perfectly 
analogous with certain forms of carbonate of lime, but which he chemically 
recognized as oxalate. Other varieties have also been described, the irregular 
disc, the well defined diamond shaped, etc. ; and all are almost invariably 
mixed with the ordinary octohedral crystals, the appearance of which is so 
well known, that but few persons hesitate to pronounce them oxalate of lime, 
when observed under the microscope. This is wrong, however ; the chemical 
character of these crystals, as well as that of all others, should always be 
ascertained, because their appearance under the miscroscope may deceive the 
most experienced. Urates have been found presenting the dumb bell form ; 
carbonate of lime, that of discs ; uric acid, of small diamond shaped crystals; 
and chloride of sodium from presence of urea, of octohedrons. 

Chemical Characters. Oxalate of lime may be confounded with crystals of 
ammonio-magnesian phosphate, of carbonate of lime, and of uric acid. A 
drop of acetic acid passed under the thin glass cover, dissolves the first two 
(giving effervescence with the carbonate), and a drop of liquor potassa will 
dissolve the uric acid, — in each instance leaving the oxalic acid intact. As 
to chloride of sodium crystals, they are never found in unconcentrated urine, 
being soluble in water. — Oxalate of lime is insoluble in water, in acetic acid, 
and in liquor potassa, and ammonia, but is soluble in nitric or hydrochloric 
acid without effervescence. The dumb bells, kept in liquid for any length 
of time, gradually pass into octohedra ; they give splendid colors under 
polarized light, — the octohedra very faintly under peculiar management. 
When remaining in acetic acid for some time, the dumb bells lose their crys- 
talline substance, leaving a skeleton, as it were, of the original shape of 
the crystal. If oxalate of lime be calcined in a platinum capsule, a drop 
of acetic or hydrochloric acid, added to the residue (carbonate of lime), gives 
rise to effervescence from disengagement of carbonic acid gas ; and if the 
remaining lime be treated with oxalate of ammonia, crystals of oxalate of 
lime will be formed anew. See Phosphates, Micro -chemical Diagnosis of Earthy 
Phosphates, etc. 

Clinical Import. When the presence of oxalate of lime crystals is persist- 
ent, it is due to some abnormal condition, not as a cause but as an effect, and 
this is terjned ozaluria. Thus, it often accompanies dyspepsia, affections of the 
respiratory organs, and other pathological conditions which occasion a dimi- 
nution of oxygen in the system, or, in which there is mal-assimilation of 
food in primary digestion, and, hence, its presence will be an indication of 
the existence of such conditions, to be determined by other investigations 
than those solely derived from the urine. When the presence of these crys- 



OXA 138 OX A 

tale in the urine is temporary, an explanation must be sought for in one or 
or more of the causes hereafter referred to, thus : — 1. It may proceed from 
certain vegetables, etc., used as diet, as, cauliflower, asparagus, garlic, goose- 
berries, bananas, turnips, tomatoes, water-cresses, carrots, onion, sorrel, pars- 
nips, apples, sugar in excess, rhubarb plant, etc.; or, from medicines, as, 
gentian, rhubarb, squills, valerian, canella, elder, etc. It is not always crys- 
talline at the time of voiding, but becomes so when the urine cools. — 2. It may 
proceed from the metamorphosis of vegetable, animal, or mineral substances ; 
for example, by the interrupted oxidation of uric acid, and the imperfect 
oxidation of saccharine and starchy bodies, as well as of salts of organic 
acids, which instead of being completely transformed into carbonic acid and 
urea, pass partly into the state of oxalates. — 3. It likewise appears after 
drinking alkaline waters, carbonated drinks, fermented liquors, spark- 
ling wines, lime in drinking water, etc., especially with dyspeptics. — 4. 
Dalton observes that when oxalate of lime is observed in urine that has been 
exposed for 24 or 48 hours to the action of the air, it may be due to acid fer- 
mentation. May not the same cause occurring in the kidneys, ureters, or blad- 
der, exist, when this oxalate is found in urine just passed without any con- 
stitutional symptoms being manifested ? 

As oxalate of lime is insoluble in water, how does it pass through the walls 
of the renal capillaries into the urine ? The researches of Neubauer, Mod- 
derman, and others, have proven that this salt is soluble to a certain degree 
in the acid phosphate of soda, and that its solubility is favored by chloride of 
sodium and urea. And the acid phosphate of soda has been advised as an 
internal remedy, in cases where mineral acids and tonics have failed. — Oxa- 
late of lime is often present in the urine of patients convalescing from 
acute diseases. — Crystals of oxalate of lime may be procured by carefully 
adding a dilute solution of oxalate of ammonia to normal urine just voided, 
and allowing it to stand for a short time ; the precipitate will contain various 
forms. They may frequently be procured after eating some sorrel, water- 
cress, or rhubarb plant, during a meal, and subsequently collecting the urine. 
In the nubecula which forms during cooling, many beautiful octohedral crys- 
tals of the oxalate will be found imprisoned in a small quantity of mucus. 
See Oxaluria. 

Oxalate of Urea. See Urea. 

Oxalic Acid. This poisonous acid is one of the most powerful among the 
organic acids, and appears to be constantly present in the blood in minute 
quantity, being excreted from the kidneys in certain unhealthy conditions, or 
after the ingestion of medicines or articles of diet containing it, as, for in- 
stance, rhubarb, onions, etc. When oxalic acids or oxalates have been taken 
in considerable quantity, or for a period of time, free oxalic acid may exist 
in the urine, but, more generally, it occurs in combination with lime, forming 
oxalate of lime. Free oxalic acid may be detected in urine, by adding a few 
drops of acetic acid to a drachm or two of the suspected urine, previously 
neutralized by ammonia, and then adding a solution of chloride of lime; a 



OXA 139 OXA 

white precipitate occurs, which after a few hours' standing will be deposited 
in the form of crystals of oxalate of lime. — A quantitative estimation of 
oxalic acid present in urine is not always so easily effected. Lehman advises 
to take, from the collected urine of 24 hours, 200 c. c, add a little milk of 
lime to it, filter, and evaporate to dryness. Acidulate the residue with acetic 
acid, and treat it with moderately concentrated alcohol ; agitate this alcoholic 
solution with about 50 per cent, of ether. The insoluble precipitate formed 
of oxalic acid is collected on a filter, washed, dried, and weighed. From 
this may be estimated the whole amount passed in the 24 hours ; thus, if 200 
c. c. of urine contain 5 grammes of oxalate of lime, what will the amount 

(1,000 c. c.) passed in the 24 hours contain? — — j- — =25 grammes. From 

this, the amount of oxalic acid is to be determined. 

When oxalic acid exists in the urine, free or as a salt of lime, it may be 
derived from food or medicines ; but when it exists as the result of disease it 
is due to an interrupted retrogade metamorphosis of uric acid (creatin, leu- 
cin, tyrosin, lactic, acid, etc.), and of the albuminoid group of foods. Perfect 
oxidation of uric acid changes it into urea and carbonic acid; imperfect 
oxidation into urea, carbonic acid; and oxalic acid, in proportion to the 
degree of oxidation. Schunk, who has devoted considerable attention to this 
subject, found oxaluric acid in urine ; it being the result of oxidation of uric 
acid. This acid may readily be converted into oxalic acid, in any portion of 
the urinary passages, or, even after the urine has been discharged from the 
bladder, and thus ultimately give rise to oxalate of lime formations. 

Oxaluria. Also erroneously termed oxalic acid diathesis, is that condition 
of the system in which there is a deposit of oxalate of lime in the urine 
within 24 hours after its discharge, and which deposit persists daily for weeks 
or months. It is common in nervous and dyspeptic diseases, where impaired 
nutrition exists, as well as in bronchitis, phthisis, catarrh, pneumonia, em- 
physema, also heart and liver affections, in which there is an imperfect 
oxygenization of the blood. The persistence of this oxalate in the urine in- 
dicates the existence of oxalic acid in the blood, which slowly poisons the 
brain and spinal cord. These crystals are almost invariably present in the 
urine of persons affected with spermatorrhea. The symptoms accompanying 
oxaluria are variable, being generally of a nervous and dyspeptic character; 
as, more or less depression of the vital forces, melancholy, excitable disposi- 
tion, inability for mental or physical exertion, distaste for society, deficient 
or absent sexual power, pain or weight in the lumbar region, irritability of 
the neck of the bladder, gradual derangement of the general health, and 
confirmed hypochondriasis. When the urine is alkaline, or neutral, calculus, 
or disease of the bladder, may be present; when the oxalate exists in an 
albuminous urine, or in urine containing renal casts, there may be some 
disease of the kidneys, or, these conditions in the urine may be the result of 
the mechanical irritation produced in the renal apparatus by the oxalate 
crystals. Blows across the loins, and a rough catheterism, are stated to have 



OXI 140 PAV 

also occasioned oxalate deposits in the urine. It must, finally, be observed, 
that cases of oxaluria frequently exist, in which no symptoms or other mani- 
festations of disease can be detected, the persons being to all appearance, and 
as far as feelings are concerned, quite healthy; and which cases are very 
probably due to the formation of oxalate of lime crystals in the kidneys, 
ureters, or bladder, from the process of fermentation. 

In instances where oxalates and phosphates are found in the urine together, 
or where they appear in successive alternations, the formation of a calculus 
is more especially to be feared. The remedies are nitro-muriatic acid, bitter 
vegetable tonics, nitrate of ammonia, inhalation of oxygen, cold bath with 
frictions, attention to bowels, digestive functions, and skin, acid phosphate of 
soda, plain digestible diet, avoidance of all the articles named under oxalate 
of lime, as well as of fatigue, sexual excesses, and excessive mental applica- 
tion ; if anemia be present, tincture of chloride of iron, pyrophosphate of 
iron, ammonio-tartrate of iron, etc., and for stimulants, when necessary, 
whisky, brandy, gin. 

Oxidam Uricnm. Oxidum Uranicum. See Xanthine. 

Ozonic Ether? (Antozonic Ether.) See Ethereal Solution of Peroxide of 
Hydrogen. 



Parabanic Acid. This acid is one of the derivatives from uric acid, and 
like all the other derivates of this acid may be converted into urea and oxalic 
acid. It is procured from uric acid by dissolving this in nitric acid, and 
then evaporating the solution until no more gas is evolved, and until the 
alloxan originally produced is decomposed. 

Pavy's Test, or Solution. (See Copper.) Take of sulphate of copper 
320 grains, neutral tartrate of potassa 640 grains, caustic potassa 1,280 
grains, distilled water 20 fluid ounces. Dissolve the neutral tartrate and the 
potassa fusa in one portion of the water, and the sulphate of copper in the 
other ■ afterwards mix the two solutions. Label, " Pavy's Cupro-Potassic Solu- 
tion. Detection of Sugar." This differs chiefly from Fehling's in the substitu- 
tion of caustic potassa for the caustic soda, and requires similar care and 
management in its preparation and preservation. If at any time this solu- 
tion gives any precipitate upon being boiled, it is not fit for use, but may be 
made as good as ever by a fresh addition of caustic potassa. 

This is an excellent modification of Fehling's test for sugar. But as it 
gradually decomposes upon standing, it is better to keep the several articles 
in solution separately and mix them when required, as follows: — 1. Dissolve 
pure sulphate of copper 160 grains, in distilled water 5 fluid ounces. Label, 
11 Solution of Copper. Pavy." — 2 Dissolve neutral tartrate of potassa 320 
grains in distilled water 2 J fluid ounces. Label, "Solution Tartrate Potassa. 



PAV 141 PAV 

Pavy." — 3. Dissolve pure caustic potassa 640 grains in distilled water 2£ fluid 
ounces. Sp. gr. 1.12. Label, "Solution Potassa. Pavy." When required for 
use mix 2 fluidrachms of the sulph. copper solution with 1 fluidrachm of 
the tart, potass, solution, and then add 1 fluidrachm of the caustic potass, 
solution. 100 minims of this test solution are decolorized by half a grain of 
sugar; that is, in other words, half a grain of sugar will convert the whole 
of the oxide of copper in 100 minims of the test liquid into the state of sub- 
oxide. As diabetic urine undergoes rapid decomposition, especially in warm 
weather, the analysis should be made, if possible, immediately after the 
urination. 

To use this solution, dilute the diabetic urine with four times its bulk of 
distilled water ; place it in a graduated pipette, and let it fall drop by drop 
into a porcelain capsule containing exactly 100 minims of the above test 
solution along with a piece of caustic potassa, about the average size of a 
pea, which solution must be kept gently boiling all the time. As soon as the 
blue color has disappeared and an orange color appears, read off the amount 
of diluted urine employed. The number of minims employed will give the 
amount of sugar per fluid ounce, as in the table below. But, as the urine is 
diluted, and only represents the fifth part of an ounce, the amount given in 
the table must be multiplied by 5, to get the amount of sugar in the ounce of 
urine. Thus, if 28 minims of diluted urine were required to decolorize the 
100 minims of test solution, according to the table this would give 8.57 
grains of sugar to the fluid ounce ; but this is only |th of an ounce, the urine 
being diluted, and must be multiplied by 5, which gives 42.85 grains of sugar 
in an undiluted fluid ounce of urine. Three gallons of urine per day, are 
384 fluid ounces, yielding 16,454.40 grains of sugar. 

If there are only traces of sugar in the urine, concentrate by evaporation, 
and then treat with acetate of lead to get rid of coloring matter, urates, and 
phosphates, and then filter. Under ordinary circumstances no preparation 
of the urine is required for the application of this test. — Should a small 
quantity of the urine be boiled with some crystals of sulphate of soda, q. s., 
to insure a total separation of all that is vegetable, and then filtered, the 
soda will not interfere with the test. 



PEN 



142 
IX. Table, 



PEN 



Shotting the Quantity, in Troy Grains, of Sugar per Fluid Ounce, for Minims 
(from 15 to 100) Required to Decolorize 100 Minims of F. W. Pavy's Test-fluid. 



Minims 


Sugar 


Minims 


Sugar 


Minims 


Sugar 


to 


per Fluid-ounce 


to 


per Fluid-ounce 


to 


perFluid-ounce 


Decolorize. 


in Grains. 


Decolorize. 


in Grains. 


Decolorize. 


in Grains. 


15 


16. 


44 


5.45 


73 


3.28 


16 


15. 


45 


5.33 


74 


3.24 


17 


14.11 


46 


5.21 


75 


3.20 


18 


13.33 


47 


5.10 


76 


3.15 


19 


12.63 


48 


5. 


77 


3.11 


20 


12. 


49 


4.89 


78 


3.07 


21 


11.42 


50 


4.80 


79 


3.03 


22 


10.90 


51 


4.70 


80 


3. 


23 


10.43 


52 


4.61 


81 


2.96 


24 


10. 


53 


4.52 


82 


2.92 


25 


9.60 


54 


4.44 


83 


289 


26 


9.23 


55 


4.36 


84 


2.85 


27 


8.88 


56 


4.28 


85 


2.82 


28 


8.57 


57 


4.21 


86 


2.79 


29 


8.27 


58 


4.13 


87 


275 


30 


8. 


59 


4.06 


88 


2.72 


31 


7.74 


60 


4. 


89 


2.69 


32 


7.50 


61 


3.93 


90 


2.66 


33 


7.27 


62 


3.87 


91 


2.63 


34 


7.05 


63 


3.80 


92 


2.60 


35 


6.85 


64 


3.75 


93 


2.58 


36 


6.66 


65 


3.69 


94 


2.55 


37 


6.48 


66 


3.63 


95 


2.52 


38 


6.31 


67- 


3.58 


96 


2.50 


39 


6.15 


68 


3.52 


97 


2.47 


40 


6. 


69 


3.47 


98 


2.44 


41 


5.85 


70 


3.42 


99 


2.42 


42 


5.71 


71 


3.38 


100 


2.40 


43 


5.58 

1 


72 


3.33 







Penicilium Olaucnm. Mould Fungus. See Fig. 31, page 178. This 
fungus is one of the most common met with on decaying vegetable sub- 
stances, and especially on vinegar, albuminous, and semi-fluid matters. It 
consists of pedicels or partitioned tubes, terminating in a repeatedly bifur- 
cated pencil, each branch of which bears a moniliform row of spores. It is 
common in acid urine containing organic substances, and may be seen in its 
various phases of development, as, spores, round or oval cells ; thallus, 
branches or interlacing fibres ; and aerial fructification or mould, in which 
a downy pile of threads grow out into the air. The spores show a nucleus, 
tend to an oval or elongated form, are green or blueish,and after fructifi- 
cation may be found in the bottom of the urine. The fungus should be stud- 
ied on preserves, and certain kinds of cheese ; it may be recognized by its 



PET 143 PHO 

partitioned tubes terminating in a pencil of filaments carrying the spores 
arranged in a bead -like manner. Solution of iodine renders them more dis- 
tinct, colors them yellowish, and arrests any movements. See Fungi; Torula; 
Vegetable Organisms. 

Pettenhofer's Tost. This test is for the determination of the bile acids in 
urine, and is based upon the action of sulphuric acid upon the bile acids in 
presence of sugar, producing a purple-violet color. The original process has 
been simplified by Neukomm. and others, which see under Bile Acids. But 
all these are frequently impracticable clinically, and may even fail. Proba- 
bly the best process is the following, which, however, requires considerable 
time and some careful management : Evaporate on a water bath, 200 or 250 
c. c. of the urine to be investigated. Add an excess of absolute alcohol to the 
dry residue, filter, and to the filtered liquid add a large excess of ether. The 
precipitated bile acids are separated by filtration, dissolved in distilled water, 
and decolorized by filtering through animal charcoal. From 4 to 6 c. c. of 
the colorless liquid are then placed in a porcelain capsule or test tube, and 
one drop of a very dilute syrup of cane sugar added. Now gradually drop 
sulphuric acid into the mixture, keeping down an excess of temperature by 
holding the tube or capsule in cold water, and when an amount of acid has 
been added nearly equal to that of the fluid under investigation, the charac- 
teristic purple- violet color will appear if bile acid be present. 

Phosphates. The phosphates existing in the urine are those with the alk- 
aline bases, soda and potassa, and those with the earthy bases, lime and mag- 
nesia; in healthy urine these, are never spontaneously deposited, but are held 
in solution, owing to the presence of certain salts and the acidity of this fluid. 
But as soon as the urine undergoes alkaline fermentation, these phosphates, 
becoming insoluble, are deposited in the form of amorphous or crystalline 
precipitates. They are likewise met with in neutral urine, or urine rendered 
slightly alkaline from the use of mineral waters, etc. In normal urine 
the alkaline phosphates are in greater amount than the earthy, the latter 
varying according to circumstances, sometimes lime preponderating, at others, 
magnesia. It must likewise not be forgotten that the phosphatic salts 
are constantly subject to changes from the condition and changes occurring 
in the urine; a basic salt, with an alkaline reaction, from a very slight 
chemical change may be converted into a neutral, and even into an acid salt; 
this is due to the changes occurring in the organic acids of the urine. — 
Earthy phosphates are soluble only in acid solutions; alkaline phosphates 
are very soluble, and do not precipitate with ammonia. The earthy phos- 
phates are the only ones of these several varieties, met with in the sediment 
of urine, they are daily observed, and are the most important among the 
phosphates; we will, therefore, in order to facilitate investigation, first give 
their common and distinctive characters, etc., and then the determination of 
phosphates in general. 



PHO 



144 



PHO 



$ I. Common Characters. 

Phosphate of Lime and Ammonio-magnesian. 

1. Insoluble in water. 

2. Insoluble in alkaline solutions, which consequently precipitate them 
from their solutions. 

3. Soluble in acids, even in acetic acid. 

X II. Distinctive Characters. 



Phosphate of IAme. 



Nothing. 



Dissolved in acetic acid, its solu- 
tion neutralized with carbonate of 
soda, gives a precipitate of oxalate of 
lime, when solution of oxalate of 
ammonia is added to it. 

Affects the amorphous condition ; 
rarely crystalline. 



Ammonio-magnesian Phosphate. 

Heated in a glass tube with a so- 
lution of caustic alkali, it disengages 
ammonia, which may be recognized 
by its odor, by litmus paper, and by 
the glass rod dipped in hydrochloric 
acid. 

Nothing, especially if care has 
been taken to add a few drops of 
solution of hydrochlorate of ammo- 
nia to the acetic solution. 



Always crystallized. 



III. Characters of the Phosphatic Sediments. 

Deposits of the phosphates are always white, unless they are colored by 
abnormal coloring matters in the urine, as blood, senna, bile pigment, etc. 
They are soluble in hydrochloric and acetic acids, insoluble in ammonia and 
caustic alkaline solutions. Upon heating the urine, this deposit undergoes 
no change, unless it be an agglomeration in small masses. Mucus, pus, or 
blood, may at the same time be present in the urine, and mask the deposit, in 
which case we must proceed as follows : — Treat the sediment with hydro- 
chloric acid (which dissolves the phosphates more rapidly than acetic acid, 
without decomposing them) until the salts are completely dissolved; then 
filter. The filtered liquor contains the phosphates in solution, while the 
elements of organic origin, pus, blood, mucus, albumen, remain on the filter. 
The phosphates may now be precipitated by ammonia and then examined 
under the microscope. The phosphate of lime will be found in very pale 
amorphous grains, united by patches, or in flaky groups, and the ammonio- 
magnesian phosphate will be in stellar or fern-like foliaceous crystals. If 
we wait a little time, the ordinary prismatic crystals will also be observed. — 
If it be desired to make a chemical analysis of the precipitate thus obtained, 
dissolve it in acetic acid, and proceed as named hereafter, under Phosphates 
in General; Detection, Separation, and Estimation. 

Microscopic Characters. The two phosphates are more generally together in 



PHO 



145 



PHO 



the deposits ; rarely the one without the other. The distinctive characters 
of each phosphate seen under the microscope, are as follows : — 

1. Phosphate of Lime. Basic Phosphate of Lime; Basic Calcic, or Calcium 
Phosphate. (See Fig. 24, page 146.) This is present in an amorphous 
state in the form of extremely transparent, irregular flakes or patches. A 
certain amount of experience is required to recognize them under the micro- 
scope; their transparency likewise enables us to distinguish them from 
certain very neighboring forms of urates, the granules of which are some- 
what larger, and especially darker. — This is the usual aspect of phosphate of 
lime in the sediments. But it may be met with under many other forms, 
which may be simply referred to, as they have been hardly studied, and are 
not well known : The most common in the sediments are the forms in wand, 
in small crosses, or in beads. These three varieties are observed together, 
and result from the grouping of small grains of phosphate of lime. They 
have been seen in a deposit of bilious urine. — The following are the several 
varieties under which phosphate of lime may appear : 

Forms Assumed by Phosphate of Lime. 
Small pale granules grouped in irregular patches. 
Small spherules with dark outlines, isolated either in 
Sausage form, or in beads (3 or 4). 
cross. 

hour glass or dumb bells. 
'- Isolated. 



Amorphous or 
in badly denned - 
crystals. 



Crystallized. 



( Sai 

1 In 
I In 



In needles. ■{ Grouped. 



In fasciculi, tufts, sheaf- 
like bundles. 
In broom form. 
In fan shape. 
In stellar form. 



In acicular 
prisms. 



Isolated. 
Grouped. 



The amorphous forms are observed in the sediments. The crystalline forms 
have been obtained by precipitating the phosphate of lime in fresh urine with 
carbonate of soda. By this method an amorphous precipitate is obtained, in 
which, after several hours, a variable quantity of crystals will be mixed. 
Hassal states that, though rapidly precipitated, phosphate of lime forms an 
amorphous powder, when precipitated slowly, prismatic crystals of this salt 
are formed, 2 CaO, HO, P0 5 -j- 3 HO. Chemical analysis of this precipitate 
has proven that it never contains magnesia ; operating according to the pro- 
cess named on page 152. — However, Vogel has found crystalline sediments 
of phosphate of lime sometimes alone (the most frequent), sometimes mixed 
with ammonio-magnesian phosphate. The size, the form, and the grouping 
of the crystals in the sediment are, he states, extremely variable. Sometimes 
they are isolated, at other times aggregated. At times they are delicate, in 
needle form, and then in crossing each other at right angle, being placed one 
upon the other, they often form masses of globular crystals; at other times 
they are thin and with perfectly smooth surfaces, their extremities termin- 
10 



PHO 



146 



PHO 



ating in acute points. Very often the crystals are thick, more or less cunei- 
form, and adhering together by their pointed extremities so as to describe a 
more or less considerable portion of a circle (rosettes). The urine depositing 
crystalline phosphate of lime in large amount has ordinarily a pale color, is 
abundant, with a feebly acid reaction, but it readily becomes alkaline under 
the influence of the mucus with which it is mixed. According to Bence 
Jones, this deposit can be produced at will by administering lime water, or 
the acetate of lime. — Two general remarks may be made concerning the forms 
which phosphate of lime may assume : 

a. When it is amorphous, it is transparent, or, if its granules are dark they 
are in groups of two or three, never more than four or five together, and this 
separates them from the granules of urates, which are yellowish and much 
larger when they are isolated, and ramified like sprigs of moss when they are 
agglomerated. 

b. When crystallized, its crystals manifest a great tendency to grouping, 
which distinguishes them from the habitual solitary ones of ammonio-mag- 
nesian phosphate. This salt is of greater pathological importance than the 
triple phosphates. 



These rules, be it understood, are not absolute, 
Fig. 24. 




A. Prismatic crystals of triple phosphate. 

B. Penniform crystals of triple phosphate. 

C. Stellar and foliaceous crystals of triple phosphate. 

D. Mixed phosphates; amorphous phosphate of lime. 

A few drops of solution of sesquicarbonate of am- 
monia (one drachm of the salt to one fluid ounce of 
distilled water), added to urine passed after the 
digestion of a meal, will precipitate the neutral 
triple phosphate. 



and their exactness must be 
ascertained by micro-chemi- 
cal analysis, as indicated 
hereafter. 

Phosphate of lime is the pre- 
cipitate foi~med on heating the 
urine, or, on treating it with 
an alkaline solution (soda or 
potassa). However the pre- 
cipitation by heat alone oc- 
curs only when the urine 
contains an excess of phos- 
phate; it may be distin- 
guished from albumen by 
the addition of a little nitric 
acid, which dissolves the 
phosphate leaving the albu- 
men intact. 

2. Ammonio - magnesian 
Phosphate. Triple Phosphate. 
This deposit in small 
amount may be normally 
present in slightly acid or 
neutral urine. But it al- 
ways appears when the 
urine becomes alkaline. In 
some diseases of the spinal 



PHO 147 PHO 

cord (paraplegia), and especially in chronic affections of the bladder, sedi- 
ments are observed consisting solely of crystals of ammonio-magnesian 
phosphate. These crystals are remarkable for their glistening, glass-like 
aspect, the regularity of their form, and their large size. The coffin- lid j "onn 
is the more frequent ; it may be termed the standard form. These are vari- 
eties easy to recognize and which every one may observe. See Fig. 24. 

When this phosphate is suddenly precipitated by the addition of an excess 
of ammonia to the urine, it assumes a different, but no less characteristic, 
appearance; the penniform or foliaceous crystals thus obtained are generally 
known as fern-leaf crystah, which gives a good idea of their appearance. See 
Fig. 24. — Sediments of ammonio-magnesian phosphate are almost always 
accompanied with phosphate of lime, either amorphous or in granules ; they 
may likewise be mixed with finely granulated deposits of whitish alkaline 
urates; roundish grains of carbonate of lime; and octohedral crystals of 
oxalate of lime. The mode of distinguishing these deposits from each other, 
chemically under the microscope is as follows : 

IV. Micro-chemical Diagnosis of Earthy Phosphates, and of other Crys- 
talline Deposits. 

The earthy phosphates are dissolved ; the phos- 
phate of lime more slowly than the ammonio- 
magnesian phosphate. 

The urates equally disappear, but are replaced 
fo"heiop F o rde7oSron I ^ i( j ozenge sha P ed > or S( 3 uare crystals of uric 

Carbonate of lime, if present, which is rare, 
is dissolved, giving out gas bubbles.* 
Remain undissolved j Oxalate of lime. 
[ in the preparation. \ Uric acid. 



Add a drop of acetic acid 



Add a drop of carbonate 
of soda to another drop of 
the deposit. 



Are dissolved. 



{ 



Urates. 
Uric acid.. 

{Earthy phosphate. 
Oxalate of lime 
Carbonate of lime. 



* (The bubbles of gas that rise in the liquid of the preparation, and which 
are due to the decomposition of the carbonate of ammonia of the alkaline 
urine by the acetic acid, must not be confounded with those disengaged by 
the carbonate of lime. See Urinary Sediments. Action of Acetic Acid.) 

Each operation of the above table, must be made upon separate drops of 
the deposit, and no two successively upon the same drop. 

Separation of Phosphate of Lime from the Ammonio-magnesian Phosphate, under 
the Microscope. In certain instances this separation is very difficult to effect. 
The best method is to add a drop of solution of oxalate of ammonia to a drop 
of the urine containing the mixture of phosphate of lime and ammonio-mag- 
nesian phosphate. The amorphous mass of phosphate of lime will disappear, 
and be replaced by small squares of oxalate of lime, while the crystals of 
ammonio-magnesian phosphate will remain unaffected. 



PHO 148 PHO 

Study of the Earthy Phosphates. In hospitals this study can be made very 
readily with the urine of patients laboring under vesical catarrh. Normal 
urine will also yield them if permitted to undergo putrefaction. — In order to 
examine each phosphate separately, treat fresh normal urine with carbonate 
of soda ; a precipitate of phosphate of lime will be obtained, which permit 
to become deposited. Then treat the clear supernatant liquid by an excess of 
ammonia, and allow it to rest for several hours ; a light precipitate will be 
obtained of ammonio-magnesian phosphate, in the form of foliaceous, stel- 
lated, or penniform, and sometimes in isolated, crystals. — When fresh urine 
is treated by ammonia, the precipitate formed will consist of a mixture of 
the triple phosphate and phosphate of lime.— It is very difficult, if not 
impossible, to determine an excess of earthy phosphates, except by quantita- 
tive analysis. A normal or diminished amount of these phosphates may be 
precipitated in an alkaline urine ; while on the other hand an excessive 
quantity may be held in solution if the urine be very acid. The following 
quantitative analysis may be made : Take 50 c. c. of urine and add ammonia 
to it; filter to remove the earthy phosphates formed. To the filtered liquor 
add a little carbonate of ammonia, and then some sulphate of magnesia; 
allow this to stand for 12 or 24 hours, and filter to remove the precipitated 
penniform crystals of triple phosphate. Dry and weigh each precipitate ; the 
first precipitate obtained will give the amount of the earthy phosphates of 
lime and magnesia in the urine employed; the second, the amount of the 
alkaline phosphates of soda and potassa. And from this, the amount of each 
in the urine of 24 hours may be calculated. It must not be forgotten in the 
analyses for phosphates, that certain salts of magnesia taken internally tem- 
porarily increase this substance, and, consequently occasion a phosphatic 
deposit, in the urine. 

Quantity of Earthy Phosphates Eliminated Daily. Acccording to Bencke, a 
man eliminates by urine in 24 hours, 1 grm .20 of earthy phosphates. Ac- 
cording to ISTeubauer, in 100 parts of earthy phosphates there are 33 parts of 
phosphate of lime, and 67 parts of phosphate of magnesia. It must be borne 
in mind that a considerable quantity of earthy phosphates is eliminated with 
the feces. It is probable that the excess of phosphates in the food eaten, is 
rejected by this route. For, according to Neubauer, the ingested salts of lime 
do not pass through the urine, although Roberts sustains the contrary. — As 
the rule, phosphates exist in smaller proportion in young children than in 
adults ; old persons have an abundance of phosphates in their urine. Dietj 
and exercise, both mental and physical, exert, however, an influence upon 
this amount. Beef, milk, potatoes, and bread, are exceedingly rich in phos- 
phates; while starchy, saccharine, and fatty foods contain but small amounts, 
if any. 

Clinical Import. The presence of earthy phosphatic deposits in the urine 
apprises the physician of an alkaline, or neutral, condition of this fluid, the 
resulting consequences of which he should be aware, and should, therefore, 
correctly ascertain the cause of this condition, and promptly employ the ap- 



PHO 149 PHO 

propriate remedy. — If the urine contains a sediment of earthy phosphates at 
the moment it is voided, it is evident that this sediment must originate in the 
inner urinary passages, and then the formation of vesical calculi is to be feared. 
An increase of the phosphates may be present in cases of phrenitis, injuries 
to the head; paralysis, especially when the result of some malady of the spinal 
cord, rickets, etc.; but in such cases, it is due to the disease, which must be 
removed by appropriate treatment in order to remove the abnormal amount 
of the phosphates. In addition to which, measures must be taken to remove 
any local cause that may exist favoring the production of gravel or stone, as 
the presence of mucus, fibrin, blood, etc. 

If the precipitate of earthy phosphates is entirely amorphous, it is evident 
that the alkali causing it is not ammonia, and calculous formations are not 
so much to be feared. But should the deposit contain crystals of triple phos- 
phate, the presence of ammonia, probably from decomposition of urea, is 
indicated, and the more persistent this deposit, and the nearer the period of 
emission at which it occurs, the greater reason for apprehending the form- 
ation of calculi, irritation and ulceration of the lining membrane of the 
bladder, or, some affection of the spinal cord. See Alkaline Urine. — It has 
been supposed by many that the excretion of phosphate of lime by the urine 
is increased in certain osseous diseases, as, osteomalacia ; but there are very 
few researches upon this question. In a case of extensive burn, a consid- 
erable increase of earthy phosphates in the urine was observed. — Phosphates 
are found in abundance in the urine of maniacs, but are diminished in renal 
and intestinal affections, as well as in grave pneumonia, — their reappearance 
is a favorable prognosis. Phosphate of magnesia increases in meningitis, and 
diminishes in typhus and grave fevers, but reappears as convalescence comes 
on. Phosphate of magnesia, as well as creatine, abounds in the urine of those 
attacked with progressive atrophic muscular paralysis. Phosphate of lime 
augments in mollities ossium ; it is also abundant with diabetics who satiate 
their thirst, — and in meningitis, cerebral tumors, tumors of the spinal cord, 
caries, osseous tumors, and tertiary syphilis. 

It must not be forgotten, however, that amorphous phosphate of lime is 
frequently present in the urine of those who are severe students, who lessen 
their hours of sleep, who exhaust their nervous systems, who use certain 
articles of diet, citrates, tartrates, carbonates, etc. On the contrary, food or 
drink containing lime, as well as certain maladies, cancer, diabetes, etc., are 
very apt to give rise to the crystalline forms of phosphate of lime. The 
presence of ammonio-magnesian phosphate indicates an alkaline fermentation 
of the urine, due to retention of urine, vesical calculus, or vesical paralysis. 

Phosphate of Lime, Acid. Acid Calcic, or Calcium Phosphate. Biphos- 
phate of Lime. This salt exists in the urine in variable quantity in a state of 
solution. It is deposited when the urine has been evaporated to one-third, 
or one-half, its volume. The crystals are both large and very small, have 
the form of elongated hemioctohedrons, are colorless, transparent, with clear 
edges, and hardly refracting light. They may be isolated, but are more com- 



PHO 150 PHO 

monly united in twos or in more voluminous groups. This salt does not 
always crystallize, but frequently forms an amorphous layer on the surface 
of the evaporated fluid which unites into groups with the blackish spherical 
masses of urate of soda. When crystallized it is always accompanied by 
this amorphous matter which holds it in groups with the soda urate. This 
salt is very soluble in acetic acid. It must be recollected that the composi- 
tion of the phosphatic salts is constantly undergoing change, from the pres- 
ence and action of the acids and bases in the urine. 

Phosphate of Magnesia. Magnesic, or Magnesium Phosphate. This salt 
is met with in all the fluids and solids of the body, especially in the muscular 
flesh ; it has likewise been detected in pus, in the serosity of several cysts, 
in the serosity and pus of the pleura and of the peritoneum in chronic pleu- 
risy, and in the fluid of ovarian cancer, etc. It has also been found in uric 
acid, and phosphate of lime, calculi. It is generally in liquid form, though 
it may readily pass to a solid and crystalline state. From its diffusion 
throughout the system, it must perform an important part in the constitution 
of the solids and tissues, not yet determined by physiologists. The surplus 
amount of this earthy salt passes partly by stool, and partly by the urine. 
To determine its presence, reduce the solid or liquid to an ash ; dissolve this 
in very dilute hydrochloric acid ; then add to the solution hydrochlorate of 
ammonia, and ammonia, which occasions a precipitate of ammonio-magnesian 
phosphate. When the urine of herbivorous animals is evaporated, we obtain 
the phosphate of magnesia in the form of brilliant crystals, oblique prisms 
with rhomboidal base, having unequal growths on two of the vertical edges. 
However, there will often be slight differences in the aspect of these prisms. 

Phosphate of Potassa. Potassic, or Potassium Phosphate. This salt, al- 
though it has been found in the substance of the nerve centers, has been 
detected rarely, if at all, in human urine. 

Phosphate of Soda, Acid. Biphosphate of Soda. Acid Sodic, or Sodium 
Phosphate. This salt is met with in urine, and is considered one of the princi- 
ples from which this fluid derives its acidity. In fresh and acid urine it is 
almost constantly present. It may be obtained by pursuing the same process 
as given below for procuring the neutral salt. Three or four days after the 
neutral salt has crystallized, transparent, rectangular, prismatic crystals will 
be observed deposited chiefly upon the sides of the vessels, and which are 
more soluble in water than the neutral phosphate of soda. Their formation 
may be hastened by adding ether to the liquid already diluted with absolute 
alcohol. 

Phosphate of Soda, Central. Neutral Sodic, or Sodium Phosphate. Micro- 
cosmic Salt. Essential Salt of Urine. This neutral phosphate is found in all 
the solids and fluids of the system; being very soluble in water, it is almost 
always met with in a fluid state in the economy. Like the other phosphates 
in urine it may change into an acid or an alkaline salt, according to the 
chemical composition of the urine, with regard to its acid or alkaline con- 
dition. It may be obtained from the urine by first depriving it of any fat or 



PHO 151 PHO 

albumen it may contain ; then strongly concentrate the urine, decant or filter 
to separate it from the saline deposit, and to the clear liquid add absolute 
alcohol. Crystals of neutral phosphate of soda slowly form upon the sides 
of the vessel. They are in table forms derived from the rectangular prism, 
with unequal growths on their edges. When formed in urine they are almost 
always striated on the surface. If the urine is clear, the crystals are color- 
less and transparent; if it be colored, the crystals will retain some of the 
coloring matter. — Phosphate of Soda and Ammonia, Ammonio-sodic Phosphate, is 
frequently found in putrid urine containing the triple phosphates; the pris- 
matic crystals of this salt, although strongly resembling those of the ammonio- 
magnesian phosphates, are quadrangular, or of some form derived from it. 
This salt has also been called mierocosmic and fusible salt. It is only found in 
urine commencing to decompose, or that has become putrefied. Its chemical 
reactions are similar to those of the ammonio-magnesian phosphates. — For 
volumetric and other solutions of soda, see Soda, Phosphate of 

Phosphates in General. Phosphates that may be met with in urinary 
deposits, have heretofore been treated upon. (See Phosphates, Phosphate of Lime, 
Ammonio-magnesian Phosphate.) Under the present caption will be given pro- 
cesses of detection, separation, and estimation, applicable to phosphates in 
general. — Urine contains alkaline and earthy phosphates ; the alkaline are 
the phosphates of soda, either acid, neutral, or basic. Phosphate of potassa 
does not normally exist in the urine; introduced into the economy it is 
decomposed in the presence of carbonate of soda, giving phosphate of soda 
and carbonate of potassa. The earthy phosphates are those of lime and mag- 
nesia. The latter readily unites with ammonia forming the ammonio-mag- 
nesian phosphate of urinary deposits. — The presence of phosphates may be 
recognized by adding nitric acid and a little molybdate of ammonia to the 
deposit diluted with distilled water ; on heating the mixture a characteristic 
yellow color is produced. 

As the physician is not, and can not be by profession, a chemist, it must 
not be expected that he should enter into the more difficult and complicated 
chemical processes for detecting and estimating the various sediments that 
may occur in urine. But he must have reliable agents to prevent the least 
error, and, in the present instance, those, the use of which is quite easy, and 
at the same time quite exact, have been selected, and which may be prepared 
by any good pharmacist. 

Detection and Separation of Phosphates. 

Two cases may present themselves to the physician : — 1st. The urine is 
recently passed, and is clear and limpid. See I. Detection. 

2nd. The urine is turbid or sedimentary. In this case filter or decant, and 
test the clear liquid according to I. Detection. Examine the sediment under 
the microscope, and if it be desired to analyse it, see II. Separation of Phos- 
phates, etc. 



PHO 



152 



PHO 



J I. Detection. 



Add an excess of ammonia to the | 
urine under investigation, agitate, -I 
and then allow it to rest. 



Earthy phosphates are precipitated. 
See II, A. 

Alkaline phosphates remain in solu- 
tion. See II, B. 



Upon examining the precipitate obtained, as above, under the microscope, 
it will be found to consist of triple phosphates in fern-like, foliaceous, or stel- 
lar crystals (see Fig. 24), and some very pale amorphous phosphate of lime. 
(See Fig. 24.) If it be desired to precipitate only the phosphate of lime, 
add to the urine, instead of ammonia, a solution at the -^th of carbonate of 
soda. 

X. Table. 

II. Separation of Phosphates, or of their Bases. 



A. Earthy Phosphates 

r 



i. 

Throw upon 
the precipitate 
acetic acid, q. s., 
until it is com- 
pletely dissolv- 
ed. 



To the filtered 
or decanted li- ■{ 
quor add an ex- 
cess of ammonia. 



Neutralize with 
a few drops of am- 
monia, and then 
add a little hydro- 
chlorate of ammo- 
nia. 



A precipitate. 



No precipitate. 



Then add 
slowly, and in 
excess, oxalate 
of ammonia. 



A precipitate. 
Lime, in the state 
of oxalate; ascertain 
its characters under 
the microscope. 

Ammmio-maglies- 
ian phosphate re- 
mains in solution ; 
decant or filter. 
I See 2. 
Ammonio-magnesian phosphate; 
recognize its characters under the 
microscope. 

Place a little of the liquor in a 
sample tube and close it; examine it 
| in 24 hours afterwards; if there is 
[ no precipitate, it is because there is 
| no phosphate of magnesia in the 
[ urine. 



1. — If, as frequently occurs, too much ammonia has been added, so as to 
render the urine turbid, a drop or two of acetic acid will cause the turbidity 
to disappear, and we will continue adding the hydrochlorate of ammonia to 
it, the presence of which prevents the precipitation of the magnesia by 
oxalate of ammonia. This process detects very slight traces of lime. — The 
oxalate of lime, thus precipitated, appears under the microscope in the form 
of very black crystalline points, united in groups, sometimes in horse-shoe 
form, or in rosette. After a longer time the octohedral forms appear. Should 
there be any doubt concerning the formation of a precipitate, a little of the 
fluid should be set aside, to be examined 24 hours subsequently- See Fig 23. 

2. — When there is a small quantity of magnesia present, this precipitate 
always forms slowly in stellar or foliaceous crystals. 



PHO 



153 



PHO 



XI. Table. 

JII. B. AlkalinePhosphat.es. 

Divide the urine f One-third (a) will serve for the detection of phosphoric 

with ammonia (I. J acid. The remaining two-thirds (6) will serve for the 

Detection), into ] separation of the bases of the phosphates, the phosphoric 

two unequal parts. ^ acid having been recognized. 



c. Acidulate 
with nitric acid. 



b. Drive off 
the ammonia by 
boiling and then 
separate the li- 
quor into two 
parts. 



Add at least an 
equal volume of 
molybdate of am- 
monia. 



1. Add alcoholic 
solution of bichloride 
of platinum. 

2. Add solution 
of bimeta-antimoni- - 

[_ ate oj 



A yellow 
precipitate. 



No immedi- 
ate precipi- 
tate. 



A precipi- 
tate. 



A granular 
precipitate. 



Phosphoric acid, in 
the state of phospho- 
molybdate of am- 
monia, insoluble in 
acids, soluble in al- 
kalies. 

There are only 
traces of phosphoric 
acid. Heat the mix- 
ture to about 104° F. 

Potassa, in the 
state of chloroplati- 
nate, in beautiful 
yellow octohedral 
crystals. 



■I Soda. 



Fig. 25. 



It is necessary to previously recognize the presence of phosphoric acid, be- 
cause potassa and soda exist in the urine in the state of urates and sulphates. 
The presence of phosphate of potassa in the urine is doubtful. 

a. The yellow precipitate becomes attached to the sides of the glass tube 
if there is a little phosphoric acid ; under the microscope octohedral crystals, 
with very dark outlines, and appearing rounded, often united in masses ana- 
logous to frog's eggs. 

b. 1, 2. These two precipitates equally attach themselves to the walls of 
the tube; they do not form immediately, but in 12 or 24 hours. 

Estimation of Phosphates. To estimate the variations of the phosphates in 
the urine, the general method is to determine the amount of phos- 
phoric acid present. But the methods for this purpose are entirely 
too lengthy and too complicated to be performed by the physi- 
cian, who must, therefore, be satisfied by observing the daily 
variations of the earthy phosphates, precipitating them each time 
from a given volume of urine. — For instance, 10 c. c. of fresh or 
filtered urine are placed into a tube or glass jar graduated into 
fifths of a cubic centimetre, upon which 4 or 5 c. c. of ammonia 
are to be poured ; then agitate thoroughly, and allow the mixture 
to rest. On the next day the height of the precipitate in the tube 
may be read oft". This process gives accurately comparable 
results. By repeating this very simple process every day at the 
bed-side of the patient, a curve may be traced representing the 
daily variations of the terreous phosphates during the disease. — j ar Gradu- 
It has been ascertained that 1 c. c. of this precipitate of 24 hours, J'g d c l * t0 



PHO 154 PHO 

is equivalent on an average to grni .02 of earthy phosphates ; with this 
data, and knowing the volume of the urine from which this precipitate has 
been obtained, daily, the quantity of earthy phosphates passed per day in 
each litre of urine, can be readily calculated. 

Phosphoric Acid. About 2.6 to 3.5 grammes of phosphoric acid, not free, 
but united to alkalies and earths, is normally passed during each 24 hours. 
It may sometimes be desirable to estimate the quantity of phosphoric acid 
existing in the urine, and for which purpose several processes have been 
recommended. Among these, the following has been considered the best: — 
Into a beaker or porcelain capsule place 50 c. c. of the clear urine * to be 
tested, and 5 c. c. of acetate of soda solution, and heat on a water bath to about 
200° F. While still warm add to it, drop by drop from a graduated burette, 
standard solution of acetate of uranium, until a precipitate is no longer formed, 
or what is still better, until a piece of potassic ferrocyanide paper gives a brown 
or reddish-brown color when a drop of the mixture in the beaker is placed 
in contact with it, by means of a glass rod; then the operation is terminated. 
Ascertain the number of cubic centimetres of uranium solution required in 
the process, and multiply them by .005, which will give the amount of phos- 
phoric acid contained in the 50 c. c. of urine. As 1. c. c. of the uranium 
solution is equal to 0.005 gramme of phosphoric acid, the amount of this 
acid existing in the urine of 24 hours (when mixed together) may be readily 
calculated. 

* Should there be a deposit of earthy phosphates in the urine, a few drops 
of hydrochloric acid should be added to dissolve it, and then filter to remove 
any mucus present. If albumen is contained in the urine, separate it by 
boiling and then filtering. 

The above named solutions, and paper, are to be prepared as follows : — 
Standard Solution of Acetate of Uranium. ( Uranic, or Uranium Acetate.) To 20.3 
grammes of pure uranic oxide add enough strong, pure acetic acid to dis- 
solve it, and then add distilled water in sufficient quantity to make the whole 
measure exactly one litre or 1,000 c. c. Each cubic centimetre of this solu- 
tion will correspond to grm .005 of phosphoric acid. — The accuracy of the 
strength of this solution may be determined, if considered necessary, by 
placing in a beaker 50 c. c. of standard solution of phosphate of soda with 5 
c. c. of acetate of soda solution. Warm this and drop standard solution of 
acetate of uranium into it, exactly in the manner described above in the pro- 
cess for testing the urine. When the brown color has been produced, read 
off the amount of uranium solution used, and which corresponds to .1 gramme 
of phosphoric acid ; if it be not dilute enough to make 1 c. c. equal to 0.005 
gramme (or 5 milligrammes) of phosphoric acid, add a sufficient quantity of 
distilled water to make it so. — Acetate of Soda Solution. (Sodic, or Sodium 
Acetate.) Dissolve 50 grammes of pure acetate of soda in 50 c. c. of pure 
acetic acid, and add enough distilled water to make the whole measure exactly 
500 c. c. — Ferrocyanide of Potassium Paper. (Potassic, or Potassium Ferrocy- 
anide.) Saturate strips of white filtering paper with saturated solution of 



PHO 



155 



PIP 



ferrocyanide of potassium. Dry, and keep them in well stopped bottles. — 
Standard Solution of Phosphate of Soda. Dissolve 10.085 grammes of crystals 
of pure phosphate of soda, that have not undergone efflorescence, in distilled 
water, so as to make exactly 1,000 c. c. of the solution, 50 c. c. of which con- 
tain exactly 0.1 gramme of phosphoric acid. 

Phosphoruria. Phosphuria. Luminous or phosphorescent urine. But 
chiefly applied to urine in which phosphates exist in abnormal quantity. 

Phosphorus. Ordinary phosphorus is sometimes employed for the purpose 
of suddenly or slowly destroying life. When slow poisoning is resorted to, 
the physician is very apt to erroneously suppose the patient to be laboring 
under gastritis, fatty degeneration of the liver, or other internal disease. In 
these cases the phosphorus having been absorbed by the digestive organs is 
eliminated in the urine in the state of hypophosphoric acid. This acid may 
easily be detected in the urine by the following process : Place 10 or 20 c. c. 
of the suspected urine in a platinum or porcelain capsule, and add to it some 
pure nitric acid (15 or 20 drops). Slowly evaporate the fluid over a spirit 
lamp, and as the specimen of urine approaches the condition of dryness, the 
mixture suddenly takes fire, burning like a bundle of matches, which indicates 
the presence of hypophosphoric acid due to poisoning with phosphorus. 
Poulet. 

Photuria. Luminous or phosphorescent urine. 
Phthisuria. Diabetic urine. 

Pimeluria. Pimeluric. Urine containing fatty matter. 
Pipette. Drop Glass. There are several kinds of pipettes, 
taking up substances and 
conveying a drop or more 
upon a slide, or into a 
preparation, consists of a 
slender glass tube, with or 
without a bulb, from 6 to 
12 inches in length, and 
having an internal diame- 
ter of from Jgth to ^th of 
an inch ; sometimes they 
are made of larger cali- 
ber, but drawn out at one 
extremity to the desired 
fineness. This is used 
by placing one finger up- 
on the upper orifice to 
close it, and then carrying 
the other small end to the 
bottom of a vessel from 
which a sediment is to be taken ; upon raising the finger and quickly closing 
the orifice again with it, a portion of the sediment will pass into the pipette 



One, used for 
Fig 28. 



Fig. 27. 




v 



Pipette. 



Volume 
Pipettes. 



Pipette gradu- 
ated intosths. 



PLA 156 POL 

and may be conveyed to any desired point. Fig. 26. Other pipettes are 
made with bulbs, and marked to carry certain quantities of fluid ; thus, some 
carry 1 c. c; others 5 c. c; others again 10, or even 20 c. a, and so on. Fig. 
27. A third kind of pipette is made to answer the purpose of a burette in 
volumetric analysis ; it is a straight glass tube holding 50 c. c, which are 
graduated into 5ths or lOths of a c. c. Fig. 28. These are either plain for 
india rubber attachment, or are made with a glass stop-cock, to admit of the 
flowing or dropping of the fluids employed. — The best pipette for collect- 
ing urinary sediments, is a glass tube having a caliber of about one inch in 
diameter, and a length of 10 or 12 inches ; one extremity of this tube is 
tapered off to a very small orifice, and is furnished with a glass stop-cock. 
The deposit of a given urine is poured into this tube, and is allowed to again 
deposit itself. By carefully opening the stop-cock the most dense part of the 
precipitate may be obtained, drop by drop, as required. 

Planuria. The voiding of urine through other than the natural passages. 

Platinum. It must be borne in mind that platinum is injured, during 
chemical processes, by contact with lead, or with nitro-hydrochloric acid. 
This metal is also injured by the nascent silicon arising from heating silicic 
acid and carbon together in a vessel composed of it. Free chlorine, bromine, 
or iodine injure it ; caustic alkalies must not be evaporated in it to the point 
of fusion of the residue. — Solution of Bichloride of Platinum. Platinic or Pla- 
tinum Bichloride. Take of pure bichloride of platinum 1 part, alcohol of 60° 
10 parts by weight ; mix, dissolve, and place in a well-stoppered vial. Label, 
" Alcoholic Solution of Bichloride of Platinnum. Detection of Potassa." This solu- 
tion at the xoth is advised, because it is fully sufficient to detect feeble traces 
of potassa; it keeps well. This reagent precipitates potassa in fine, yellow, 
often voluminous, octohedral crystals. It also precipitates ammonia, but 
there is hardly any necessity for error in this respect, because ammoniacal 
compounds being volatile, they should, if there be necessity for it, be removed 
by heat. 

Polarizing Apparatus. A very accurate mode of determining the pres- 
ence of sugar, or of albumen, in the urine, has been based upon the optical 
properties of such solutions, and to which attention was called by M. Biot. 
An apparatus designed for the detection of sugar, is termed a saccharimeter, 
and, for the detection of albumen, an albuminimeter . M. Soleil, of Paris, and 
M. Mitscherlich. of Berlin, have each constructed instruments for this pur- 
pose ; the latter being more commonly employed in this country. The high 
price of the instrument has prevented it from coming into general use, and 
yet it is a most desirable instrument for one to have who devotes especial 
attention to diabetic affections. Mitscherlich describes the manner of using 
his polarizing apparatus as follows: — " Before commencing to determine the 
percentage of grape sugar in a liquid (urine), the operator must be satisfied 
that the apparatus is properly adjusted when at zero (0°). This is ascertained 
by placing the empty tube in its proper position, and then placing a lighted 
lamp an inch or two distant from the posterior opening of the tube, and in 



POL 



157 



POL 



Fig. 29. 




Mitscherlich's Saccharimeter. 



the axis of the tube; then, on looking 
through the anterior opening, if the in- 
strument be properly adjusted at 0°, the 
posterior opening will appear perfectly 
dark, almost black. If the arm which 
moves upon the graduated circle surround- 
ing the anterior opening be now moved 
from 0° to the right or to the left-hand 
side, the posterior opening will become 
more and more lighted up, until at last, 
when the arm is moved to 90°, an intensely 
bright circle will be observed. On ap- 
proaching the arm from 90° to 0°, the ob- 
server will notice that the posterior aper- 
ture, although the arm be exactly at 0°, 
will be faintly illuminated on the two op- 
posite margins, and that the diameter of 
the circle, which runs parallel with these 
two margins, is intensely black. This black- 
est part must exactly divide the spectrum into two halves, the arm being at 
0°; the instrument is now ready for use. 

(Diabetic urine is usually quite colorless, scarcely ever requiring treat- 
ment with animal charcoal, but simply filtration. If a solution of neutral 
acetate of lead be added to highly colored urine, nearly all the coloring mat- 
ter will be precipitated.) 

To use the polarizing apparatus, a colorless solution of sugar (filtered dia- 
betic urine) is poured into the tube, which, when filled, is put into its former 
place; then upon looking through the anterior opening, it Will be observed 
that the dark spectrum appears illuminated in colors, and on moving the 
arm towards the right, from 0° to 90°, the colors will appear in the following 
order, yellow, green, blue, violet, red. — The line between the blue and violet 
colors is the same as that which formed the darkest point of the spectrum, 
and on this line all the determinations are based.— A little practice will soon 
accustom the eye to determine the point at which the spectrum is divided 
into two equal halves, one of which is violet, and the other blue, — each color 
being of about the same intensity. — If the above named succession of colors 
are obtained on moving the arm towards the right, which is the case in solu- 
tions of grape sugar or saccharine urine, the expression is, " the liquid 
rotates towards the right," or, " turns a pencil of polarized light to the right." 
In the opposite case, " the liquid rotates towards the left." 

The angle of rotation to which the arm is moved, is proportional to the 
concentration, and the length of the column of fluid through which the 
polarized light has to pass, that is, to the length of the tube into which the 
.luid is poured. The length of this tube in Mitscherlich's saccharimeter is 
200 millimetres. — If a fluid of a certain saccharine strength be put into the 



POL 158 POT 

tube, the arm being at 0°, and it should require the arm to be moved 40° to 
the right, in order to see the right half of the spectrum red, and the left half, 
blue, the same fluid, when placed in a tube of half the length, would only 
require a movement of the arm to 20°. — On the other hand, if a solution of 
15 grammes of sugar be poured into the tube, so as to fill it, and it requires 
a rotation of 15° to show the two colors in their proper positions ; then a 
solution of 30 grammes of sugar in the same quantity of water as the 15 
grammes were dissolved in, will require double the rotation, 30°, for the test 
colors to appear. 

It has been ascertained by accurate experiments that a solution of pure 
and dry grape sugar 15 grammes, in distilled water to make exactly 50 c. c, 
will, in a tube 200 millimetres in length, turn the plane of polarization 40° 
towards the right. — Upon the basis of this experiment, the amount of sugar 
in any fluid may be readily determined. Suppose the above-name^ tube, 200 
mm. in length, be filled with a yellowish diabetic urine, or any other saccha- 
rine solution, and that to make the line between the blue and violet fall in 
the center of the spectrum, requires the arm to be moved from 0° to 30°, then 
the calculation would be as follows: As 15 grammes of sugar in 50 c. c. of 
water (at 14° C, or 57° 2 V P.), have an angle of rotation of 40°, it follows that 
the quantity of sugar present in any liquid is in proportion to this angle. 
Hence in the case above supposed, 40 : 30 : : 15 : 11.25 — or, 11.25 grammes of 
sugar will be contained in 50 c. c. of a solution, having an angle of rotation 
of 30°. With this data, we can calculate the amount of sugar contained in 
any quantity of the same solution; thus, if 50 c. c. of urine contain 28.5 
grammes of sugar, how much sugar will be contained in 600 c. c. of this 

c c. grammes, c.c. grammes. 

urine? 50 : 28.5 : : 600 : 342. A printed direction as regards the manner 
of using the apparatus, etc., accompanies each instrument. 

Polydipsia. Diabetes; with excessive thirst. 

Polyuria. Diabetes, or excessive secretion of urine; with excessive secre- 
tion of urea or other solids. 

Polyaric. See Lithuria. 

Porpliyruria. Porphyuria. A condition of the urine tending to abnor- 
mal precipitates of its coloring matter with the precipitated solids ; as, 
urates, etc. 

Potassa. Potash. As the salts of potassa almost exclusively prevail in 
the muscles, but a very small quantity is met with either in the blood or in 
the urine From 1.65 to 7.13 grammes of potassa pass in the urine of 24 
hours. When these salts are taken internally their presence or their influ- 
ence in the urine varies, according to circumstances, not satisfactorily under- 
stood. Carbonate of potassa renders the urine alkaline in health, but in 
some diseased conditions it increases the acidity of this fluid. Nitrate of 
potassa is rapidly eliminated by the urine without affecting its acidity, al- 
though it appears after a few days to diminish the quantity of urea. Acetate 
of potassa lessens the amount of water, urea, extractives, and especially the 



POT 159 POT 

earthy salts, increasing the solids and carbonates; occasionally, however, the 
water is augmented. It most generally causes alkalinity of the urine from 
formation of carbonate. Citrate and tartrate of potassa likewise occasion 
the urine to become alkaline. Chlorate of potassa increases the acidity as well 
as the urates and pigment. Sulphocyanide of potassium passes out un- 
changed. Ferrocyanide of potassium becomes ferricyanide. Iodide of potas- 
sium varies in its effects upon the urine, although after it is taken internally, 
iodine soon appears in this fluid. Parkes. Experiments upon this alkali, as 
to its effects upon the urine, have not certainly given any certain or positive 
results. When potassa exists in urine, it may be detected by solution of bichlo- 
ride of platinum. To detect chloride of potassium, crystallize the salts con- 
tained in the fluid to analyze, separate the cubic crystals which may be 
chlorides of sodium and potassium, and purify them by a new crystallization. 
When once assured that there are no other chlorides mixed with these chlo- 
rides, redissolve them in a little distilled water, and add a solution of bichlo- 
ride of platinum ; if a precipitate occurs of the double chloride of platinum 
and potassium, it indicates the presence of chloride of potassium in the urine. 
See Urate of Soda and Urate of Potassa, Bromide of Potassium, Carbonates, Chlo- 
rate of Potassa, etc. 

The following potassa tests are employed in urinary analysis: — Solution of 
Potassa. Liquor Potassa. — a. Milder Solution. Take of caustic potassa 1 part, 
distilled water 10 parts by weight; mix. — b. Stronger Sohdion. Take of liquor 
potassa 1 part, distilled water 2 parts ; mix. — Sohdion of Neutral Chromate of 
Potassa. (Neutral Potassic, or Potassium Chromate.) Take of pure neutral 
chromate of potassa 1 part, distilled water 12 parts, by weight; mix. This 
is a saturated solution. Label " Solution of Neutral Chromate of Potassa. Esti- 
mation of Chloride of Sodium." — Solution of Bimeta-antimoniate of Potassa. (Po- 
tassic, or Potassium Bimeta-antimoniate. Granular Antimoniate of Potassa.) 
Preserve any quantity of bimeta-antimoniate of potassa in a well closed flask, 
and labeled. Its solution can not be prepared in advance because it decom- 
poses in a short time, forming a neutral ammoniate. At the moment it is 
desired to use it, add 1 part of this salt to cold distilled water 250 parts, and 
agitate it for quite a length of time, as it is not very soluble; then filter to 
separate the undissolved part. The filtered solution is an excellent reagent 
for soda. But its employment requires some precautions. Thus, only such 
solutions can be tested with this reagent as contain no other bases besides 
soda and potassa. All acid liquors, must, previous to using this reagent, be 
neutralized with a little carbonate of potassa. Finally, the crystalline precip- 
itate of antimoniate of soda, is slowly thrown down, and is not produced at 
all if the liquor be very dilute, in which case it must be concentrated. When 
the precipitate occurs promptly, the crystals are boat shaped ; when slowly, 
they are cubic octohedrons, or four-sided columns tapering pyramid fashion. 
Standard Solution of Permanganate of Potassa. (Potassic, or Potassium Perman- 
ganate.) For Detection of Iron. Dissolve pure crystallized permanganate of 
potassa in some distilled water, and determine the strength of a given volume 



PUB 160 PUE 

of this solution as follows : — Take 10 c. c. of solution of ferrocyanide of potas- 
sium,* (containing 10 mgrms. of iron), and dilute it with about 50 c. c. of 
distilled water ; acidify this with pure hydrochloric acid. Place the beaker con- 
taining this solution upon a sheet of white paper, and from agraduated burette 
let drop into it some of the dilute solution of permanganate of potash, named 
above, keeping the fluid constantly in rotary motion by means of a glass rod. 
The appearance of a yellowish-red color in the liquor indicates the termina- 
tion of the process. Suppose it required 20 c. c. of the permanganate solu- 
tion to produce the red color, then 1 c. c. of this permanganate solution will 

correspond with —0.5 milligrammes of iron. — Solution of permangan- 

ate of potash is not permanent, and should therefore be made only as 
required ; and, as it is acted upon by caoutchouc, being decomposed, the 
burette employed should have a glass stop-cock. 

* Solution of Ferrocyanide of Potassium. — 7.543 grammes of pure, dry, crystal- 
lized ferrocyanide of potassium (equal to 1 gramme of iron) are dissolved in 
some distilled water, and the solution diluted to 1,000 c. c. Of this solution 
10 c. c. correspond exactly with 0.010 gramme of iron. Keep in a well 
stoppered bottle. — Neubaur and Vogel prefer to this ferrocyanide solution, 
the following: — Take of crystallized oxalic acid 1.125 grammes (equal to 1 
gramme of iron), and dissolve in distilled water, to make exactly 1,000 c. 
c. of solution. 10 c. c. of this solution, corresponding with 0.010 gramme of 
iron, are placed in a beaker, heated to boiling, treated with a little dilute 
sulphuric acid, and then subjected to the action of the permanganate of pot- 
ash solution until the red color appears. The quantity of this last solution 
required for this purpose will correspond with 0.010 gramme of iron. — 
Standard Solution of Sidphale of Potassa. (Potassic, or Potassium Sidphate.) Take 
of chemically pure sulphate of potassa, dried at 212° F., 21.778 grammes, dis- 
solve in distilled water and make 1 litre of solution. One c. c. of this solu- 
tion contains 10 milligrammes of sulphuric acid, and is exactly equivalent to 
the strong solution of the chloride of barium. Label " Standard Solution of 
Sulphate of Potassa. Analysis of Sulphuric Acid." 

Purparate of Ammonia. (Prout.) Murexide. (Liebig.) These names are 
given to the rich purple tint produced, when to a small quantity of urine is added 
a drop or two of strong nitric acid, upon a porcelain plate, then evaporated 
to dryness over a spirit lamp, and the yellowish-red residue (alloxantin) 
exposed while warm to ammoniacal vapors, or to a drop or two of ammonia. 
It is employed as a test for uric acid. If traces of uric acid are sought, an 
excess of ammonia must be avoided ; a glass rod should be moistened with* 
this alkali, blowing the vapors from this upon the residue, while the rod is 
held near it. — According to Hardy, the characteristic coloration of the uric 
acid is principally due to its modified anhydrous alloxan, then, after the 
addition of the ammonia, to the isoalloxalate of ammonium. The same 
reaction is said to occur with caffein, hypoxanthin, tyrosin, and xanthoglob- 
ulin ; Schiff consequently advises Carbonate of Silver, which see ; also Uramile. 



PUR 161 PUS 

Pnrpuric Acid. If hydrochloric acid be added to purpurate of ammonia, 
murexan is separated, and the solution contains alloxan, alloxantin, urea, 
and ammonia. We have various formula given by different chemists for 
these two substances; thus, Murexide, C 16 H 4 (N H 4 ) N 5 12 +2 Aq., and 
Murexan, C 16 H 5 N 5 12 , consequently there is no certainty as to their com- 
position. Purpuric acid in a pure state is unknown. 

Pnrpnrin. Madder Purple. A red coloring principle obtained from mad- 
der root. The name is sometimes erroneously applied to the murexide 
formation in urine. 

Pus Corpuscles. It is somewhat difficult to define pus. Its detection in 
urine absolutely necessitates the employment of the microscope. The old 
chemical processes are justly abandoned, because they do not give character- 
istic reactions. Pus may be described as a pathological, sero- albuminous 
fluid, holding in suspension anatomical elements called leucocytes (white 
globules of pus), giving to the liquid containing them an opaque milky 
aspect, and a more or less creamy consistence. Indeed, there appears to be a 
direct relation between pus, properly so called, and the blood of leucocy- 
themia. The leucocytes may be discovered in urine by means of a microscope 
having a magnifying power of 300 or 400 diameters; and whenever they are 
found in this fluid in considerable quantity, it may be affirmed that pus is 
present. But should these globules not be found, it must not be concluded 
that pus is absent, because they are rapidly destroyed under the influence of 
the ammoniacal fermentation of the urine. It must be stated that the most 
eminent histologists are not in accord concerning the question of the genesis 
of pus globules. 

As it is not designed to enter into a consideration of the several conditions 
and circumstances tending to the development of pus, but simply to its recog- 
nition in the urine, we will, therefore, proceed at once toward this object. In 
this investigation two conditions may be present: — 1st. The urine may be acid 
or neutral. If it contains pus ; it will be turbid, and there will be rapidly 
deposited an opaque white sediment, which, examined under the microscope, 
will show the pus corpuscles. If these be separated by filtration, the pres- 
ence of albumen in the filtered liquid may be determined by the means here- 
tofore advised — When only a very small quantity of pus is present, and 
when it h:is been suddenly conveyed by the passage of the urine through the 
urinary canals, it appears in this fluid in the form of more or less numerous 
filaments. This fact is observed with blennorrhagic patients, and particu- 
larly with leucorrheic women, likewise with persons after their 40th or 45th 
year, in whose urine a few pus corpuscles are often found ; in these cases, 
albumen is never found in the urine, and which is accounted for by the small 
quantity of pus contained in it. 

2d. The urine is alkaline and strongly ammoniacal. In this case the pus cor- 
puscles may not be detected, their morphological identity having been de- 
stroyed by the carbonate of ammonia, and converted into a greyish muco- 
gelatinous, closely adherent mass; the presence of pus may, therefore, be 
11 



PUS 162 PUS 

suspected, but not demonstrated. It is not rare, however, to find in the mass, 
or at the upper portion of the deposit, a certain number of still recognizable 
leucocytes. They are always accompanied with crystals of ammonio-magne- 
sian phosphate, vibriones, and filaments belonging to fungi on their way of 
development. In the filtered urine, albumen may be determined by the means 
heretofore indicated. — As this rapid decomposition of the urine is frequent 
in cases of chronic maladies of the bladder, the investigation for pus should 
be made immediately after micturition. Sometimes, however, the decompo- 
sition is completely effected in the bladder before urination ; in such case, we 
may be certain the urine contains pus. 

Chemical Characters. Acetic acid exerts, what is considered, a characteristic 
action upon pus. A drop of this acid added to a drop of pus upon the glass 
slide, determines in the interior of the leucocytes the formation of from one 
to four, generally three, distinct, very brilliant, nuclei, small, roundish, or 
curved in horse-shoe form, while the rest of the globule is so pale that its 
outline becomes nearly, if not quite, invisible. — Ammonia very rapidly dis- 
solves them, while it merely renders epithelial cells paler. — Leucocytes are 
sensible to coloring reagents ; they color much better when they are fresh. 
In the application of this property they may be readily rendered conspicuous 
in the midst of other deposits accompanying them, as, crystals, and especially 
spores, which do not retain the coloring matter. — Liquor potassa added to 
pus, as well as the carbonate of ammonia in the urine, converts it into a 
viscid, gelatinous mass, so ropy and tenaciously adherent to the walls of its 
containing vessel, as to render it difficult, if not impossible, to pour it from 
one vessel to another. Mucus is rendered more fluid and limpid by the addi- 
tion of caustic alkali, while acetic acid develops a filamentous appearance. 
The glairy mass occasioned by the action of an alkali upon pus, contains 
triple phosphates, and the filtered urine, albumen, which is seldom present in 
pure mucus deposits. 

• Microscopic Examination. — This reveals the presence of leucocytes; if the 
urine is fresh, and not alkaline, they undergo no special change; some of 
them may contain one or two nuclei, determined probably by the action of 
the urinary fluid; the others present the granular or mamellonated aspect 
common to them. The action of acetic acid has already been referred to. 
The diameter of these leucocytes varies from .008 to .011 of a millimetre, 
being larger than blood globules. They are found isolated, or united in a 
group by mucus; then they undergo deformations, becoming polygonal, or 
elongated in stick forms. In their interior, more or less voluminous and re- 
fracting fatty droplets may often be observed, and which is an indication of 
oldness ; at a more advanced stage they become disaggregated, and then the 
fatty matter becomes freely diffused throughout the fluid. Or else the fatty 
globules unite in blackish rounded groups, termed granulous bodies of Gluge. — 
Water added to the leucocytes causes them to swell, and one or more nuclei 
to appear within them. Even in feebly ammoniacal urine, the leucocytes are 
swollen, very pale, and show one or two nuclei. Their dimensions may be 



PUS 



163 



PUS 




6uch that they double in Fig. 30. 

size and become vesicular, 
then they terminate by rup- 
turing and becoming de- 
stroyed. 

If, when liquor potassa is 
added to urine containing a 
deposit, no change is effected, 
the deposit consists of phos- 
phates; if the urine is ren- 
dered clearer, but not viscid, 
urate of soda is indicated ; 
if it becomes transparent, 
viscid, or thread-like, pus is 
present; if it becomes gela- 
tiniform without clearing 
up, pus, as well as phos- 
phates, are present. Puru- 
lent urine becomes clear and 
transparent on standing; if 
phosphate be present also, 
the deposit presents two 
layers, a lower one, greyish, 
and formed of the phos- 
phates, and an upper one, very fluid, of a dull opaline blue color, and formed 
of the pus corpuscles. 

Clinical Import. — Whatever may be stated to the contrary by others, the 
presence of a rather considerable quantity of pus in the urine is always an 
inauspicious symptom. It is only with women that its constant presence 
may be observed without leading to the conclusion that there is a catarrhal 
inflammation of any portion of the urinary apparatus. In hospitals, the 
origin of this pus in the urine may always be discovered, and, in most in- 
stances, will be found to proceed from the vagina or uterus. This origin 
may, however, be excluded, by obtaining the urine by catheterism. 

The chief difficulty is here : — Pus is found in the urine ; where does it 
come from? It does not enter into the province of this work to dilate upon 
this point. It will merely be stated that pus, in small amount, associated 
with some mucus and voided with the first jet of urine, in the form of fila- 
ments, certainly indicates a chronic inflammation of the urethral mucus 
membrane, and a stricture in the way of formation. In prostatic disease, 
shreds or plugs of mucus are apt to be discharged, which are found to con- 
tain aggregated pus corpuscles and prostatic epithelia. 

The nature and appearance of the pus corpuscles may also furnish some 
indications. When they are entirely normal, sensitive to the action of acetic 
acid and of coloring agents, it may be concluded that it is laudable pus, of 



Pus globules, as they appear in urine, 400 diam- 
eters. 
Pus globules acted upon by acetic acid. 
Large organic globules, 400 diameters. 
Small organic globules. 
Coagulated albumen, in Bright's disease. 



PYC 164 QUI 

good character, furnished by a simple inflammation of the urinary mucous 
membrane. — If, on the contrary, the leucocytes are found more or less 
altered, accompanied with granular bodies, and cells of various irregular 
forms, partially destroyed or in fatty degeneration, the existence of a tuber- 
culous or cancerous affection may be suspected. However, the importance 
of these remarks must not be exaggerated. — Pus accompanied with a large 
number of renal casts, especially when several of these casts contain within 
their interior some pus corpuscles, very probably comes from the kidney 
itself (pyelitis). Undeniably, the most frequent cause of purulent urine is 
vesical catarrh. 

Pyeaiometer. Picnometer. This is a specific gravity bottle, containing a 
small thermometer in its tube for ascertaining the temperature of the fluid 
contained in it. This bottle is made to hold exactly 50 c. c. or 100 c. c. of 
distilled water at 60° F., and is provided with a glass stopper having, at its 
upper and external part, a long tube with a fine capillary canal running 
through it, which permits any air in the fluid to escape. In order to ascer- 
tain the specific gravity of urine, this vessel, well cleansed, is filled with the 
urine, the stopper properly placed in, the bottle carefully dried externally, 
and then weighed with the fluid at 60° F. By subtracting from the gross 
weight thus obtained, the weight of the empty bottle, we obtain the weight 
of a volume of urine equal to a similar volume of distilled water. By 
dividing this weight by the known weight of distilled water, the quotient 
gives the sp. gr. of the urine. Thus, the bottle filled with distilled water 
weighs 80 grammes, but when empty weighs 30 grammes ; consequently the 
water weighs 50 grammes. Now, when filled with urine the bottle weighs 
81.2 grammes, from which subtracting the weight of the empty bottle 30 
grammes, there is 51.2 grammes left for the weight of the urine. Then, as 
the weight of the water is to the weight of the urine, so is the sp. gr. of water 
1.000 to the sp. gr. of the urine ; thus, 50 : 51.2 : : 1.000 : 1.024 sp. gr. of 
the urine. 

Pyin. A peculiar albuminous substance detected in pus by Gueterbock, 
which approaches in character nearer to casein than to fibrin ; it is precip- 
itated by corrosive sublimate. 

Pyoid Corpuscles. Certain globules observed in pus which give no 
nuclei when treated by acetic acid, but simply granulations. Lebert. 

Pyoturia. Pyuria. Terms applied to urine containing pus, of which 
there are several varieties, to distinguish the origin of the pus, as, pyuria 
vesicalis, urethralis, or renalis. 



Q. 

Qrainia. When this substance is administered internally, in rather large 
doses, from 15 to 50 per cent, of it passes into the urine, in the course of from 
two to eight hours. It appears to lessen the formation of uric acid. It may 



RAB 165 RAB 

be detected in urine as follows: — 1. To 10 c. c. of the clear urine add 5 c. e. 
of chlorine water, and add to this one drop of ammonia. The formation of 
a green zone indicates the presence of quinia; of a dark brown, morphia. 
This will detect 7 ^Vu tn ot quinia, and T - \,3th oJt morphia. If morphia be 
likewise present with the quinia, the addition of one drop of nitric acid will 
convert the green into an orange red, yellow, or brown color. — 2. To 50 c. c. 
of urine add solution of pure tannin until a precipitate no longer forms ; 
separate this by filtration, add milk of lime to it, allow it to stand for a 
time, then separate the precipitate formed, wash it with distilled water, and 
then exhaust it with ethereal alcohol. Evaporate the solution, and to the 
residue add chlorine water, and then ammonia, when the green color char- 
acteristic of quinia, will appear. — 3. Bender the urine alkaline by the 
addition of liquor potassa, and then add ether and shake thoroughly together; 
the ether takes up the quinia. Separate the ether, and evaporate it. Now 
place one drop of test fluid on a glass slide, and add to it one drop, or a little, 
of the ethereal residue, obtained as above; allow time for it to be dissolved. 
Then add a very minute drop of an alcoholic solution of iodine, by means 
of a delicate capillary tube. A yellow or cinnamon colored compound of 
iodine and quinia is formed at first, and finally the beautiful rosettes or crys- 
tals of sulphate of iodo-quinia are formed ; no heat is required. Under the 
microscope, with the selenite plate, and a Nicol's prism beneath, these crys- 
tals assume the two complementary colors of the stage, — red and green, if 
the pink stage is employed, — blue and yellow, if the blue selenite stage is 
used. See Vitalis' Method. Test Fluid, 



R. 

Rabntean's Method. This is for the determination of the amount of 
ammonia in urine, and is based upon the fact that the salts of ammonia de- 
compose with great facility under the influence of the hypochlorites, and 
that all their nitrogen is set free. As urine contains urea which is also 
decomposed by hypochlorite of soda and gives oft' nitrogen, two processes are 
required in order to estimate the amount of ammonia which this fluid may 
contain in combination, or in a free state. — The hypochlorite of soda is pre- 
pared by exhausting 100 grammes of powdered chloride of lime with water re- 
cently boiled, and cooled ; then dissolving in this liquid, filtered, 200 grammes 
of crystallized carbonate of soda, finely powdered. Filter and wash the 
precipitated carbonate of lime, add the liquors together and obtain 2 litres, 
and preserve this solution in a well-closed vessel. Squibb's solution of hypo- 
chlorite of soda may be substituted for this. 

a. Ten grammes of the urine are introduced into a small balloon of 200 c. 
c. capacity ; then the vessel is filled with the solution of hypochlorite of soda 
and at once closed with a cork furnished with an abductor tube, the extremity 
of which enters within a graduated tube filled with water. Heat the balloon 



RAT 166 REN 

until there is no longer any disengagement of gas and then divide the volume 
of nitrogen which occupies the graduated tube, by 34. Let V represent the 
volume of nitrogen obtained. 

b. Lastly, boil 10 grammes of the urine with 1 gramme of carbonate of 
soda; at the end of 5 minutes of ebullition, there will be no longer any am- 
moniacal compound. The filtered and cooled liquids are now treated with 
hypochlorite of soda, the same as named above in a. Let V 1 represent the 
volume of nitrogen obtained this time. The difference V — v 1 will represent 
the volume of nitrogen proceeding from the ammoniacal compounds that 
were present in the urine. Now, one volume of the nitrogen obtained corres- 
ponds to 2 volumes of ammonia; it suffices then to multiply the volume of 
nitrogen obtained by 2, to have that of the ammonia. If we have V — v 1 = 0, 
the urine contained no ammoniacal compound. 

Ratesi's Test for Sugar. This test gives a very sensible reaction with a 
mixture containing 5 parts of sugar to 1,000 of liquid. Take of concentrated 
liquor of silicate of potassa 60 grammes, bichromate of potassa 2 grammes, 
caustic potassa 2 grms .50 ; dissolve without heat. Upon one of the extrem- 
ities of several strips of tin, let fall one or two drops of the above reagent, 
and dry them with heat; then let one or two drops more fall upon the spot, 
and again dry with heat ; repeat this the third time and the apparatus is 
ready for use. Upon this dried spot let fall a drop or two of urine, or of the 
fluid suspected to hold sugar, and gently heat it. If sugar be present, the yellow 
color of the spot assumes a more or less beautiful green color of the oxide of 
chromium. — This reagent can readily be employed in city or country practice; 
the small strips of tin thus prepared can be carried in the physician's case, 
or in a portable sheath, and their use is nearly as easy and expeditious as 
that of test paper. They may be preserved for several months. M. Ratesi 
advises to examine the urine, before submitting it to a chemical examination, 
with the areometer, because if the density marks 0, or — 1, we maybe certain 
it contains no sugar. 

Renal Tube Casts. Renal Casts. Urinary Casts or Cylinders. It is often the 
case that peculiar tubular or cylindrical bodies are met with in the urine, es- 
pecially in those renal affections that have been termed Bright's disease. As 
it is of considerable importance that these should be detected when present, and 
especially in an albuminous urine, this fluid should be placed in a narrow 
conical glass, and allowed to stand for a sufficient length of time, when a 
portion of the sediment may be taken up with a pipette, or, what is still more 
preferable, the urine may be filtered through fine cambric linen, from which 
the deposit may be removed by scraping it oft' from the linen. In whichever 
way they may be separated, they should be colored in order to render them 
more distinct under the microscope. If but few casts are present in the urine 
other means may be adopted for procuring them in order to examine; thus, 
the urine may be acidulated with a little acetic acid, which will throw the 
casts down with the uric acid precipitated, — or, if the specific gravity of the 
urine be high, the urine may be diluted with distilled water, set aside for an 



KEN 167 REN 

hour, and the deposit be then examined. — Sufficiently firm pressure made with 
a needle in its handle upon the thin glass cover, just over the body under exam- 
ination, will crush it if it be a renal cast, while the thin glass may be broken by 
the pressure, or merely flatten the object should it be a fiber of wood, cotton, 
flax, wool, or silk, a hair, or other foreign body. 

The casts are probably chiefly formed in the straight uriniferous tubules ; 
they are formed by the escape of blood into the renal tubules, from capillary 
rupture or otherwise, where, the fibrin coagulating, a mould is formed of the 
shape of the tubule into which the blood has been extra vasated, and which 
subsequently passes out into the pelvis of the kidney, through the ureters 
into the bladder, and from, thence is discharged with the urine. No doubt 
many of the hyaline casts are formed in this manner. But the evidence is 
by no means wanting to favor the view that the epithelial and granular casts 
are the result of a degeneration and desquamation of the renal epithelium. 
The investigation of renal casts should, at first, be made with a weak magni- 
fying power, say of 100 or 150 diameters, which will enable us to at once 
examine a greater quantity of urine; and if the cylinders be observed, they 
can subsequently be examined under a much higher magnifying power. With 
a little experience, the physician will soon become familiar with the appear- 
ance of these casts, and at once determine them from foreign bodies in the 
urine, if he has made himself acquainted with the characters of these. A 
small drop of the urinary sediment is taken up with a pipette, and spread 
uplm the central surface of a glass slide ; this is examined under the micro- 
scope without a thin glass cover being placed over it, the pressure of which causes 
the cylinders to glide outside from beneath it. The breadth of these casts 
equals the diameter of from 2 to 6 blood corpuscles [ysVo^ to 5Fo tn °f an 
inch], their length varying from T^th to ^th of an inch (0.1693 to .5079 of 
a millimetre. 

Renal tube casts never become twisted on themselves, as is the case with 
cotton fibres. They may be rendered more distinct by coloring them with 
solution of iodine, sohition of carmine, or with a drop of solution offuchsin. 

In the examination of casts, the action of acids upon them, and upon their 
contents, must be especially noticed. When they resist the solvent action of 
hydrochloric acid, it has been supposed that the renal inflammation is cor- 
respondingly intense. If the granules of the cast are formed of protein, 
acetic acid will cause them to disappear; if of olein, they will become more 
distinct. The width of the cylinders is of some importance, as it is supposed 
that very broad casts are formed in tubules completely deprived of their epi- 
thelium, and that the prognosis is more serious when these wide casts show 
no nuclei on their sides, or an attempt at a reformation of epithelium. How- 
ever, from recent observations, the importance of the breadth of the cast 
becomes less. Two or three slides should always be examined before the 
examiner decides upon the character and significance of the casts. The 
following four varieties of casts have been admitted : 



KEN 168 KEN 



Very pale or trans- 
parent amorphous 
cylinders. 



t Renal Tube Casts. 

With badly denned m argins, f 

often twisted or varicose. j Mucous easts, a. 

With very clear margins, ■{ 

sometimes interrupted by | Hyaline casts, b. 

„ fractures. [ 

f No line of contour, epithe- f 

lial cellules united into a \ -n, ..-, ,. , 

I cylinder, proteinous or fatty | E ^elml casts, c. 
More or less dark j granulations, 

epithelial or granu- j A more or less distinct line j 

lar casts. of contour. Fundamental Fibrinous casts with 

I substance finely granular | red blood globules, d. 

[ studded with blood globules. [_ 

a. Mucous Casts. In normal urine very pale cylinders are frequently met 
with, formed of a finely granular matter, and which have badly defined mar- 
gins; they often hold renal cellules, or leucocytes, in suspension. Funcke 
considers them to be formed of mucin. They are often very abundant in the 
deposits of albuminous urine ; they are not colored by carmine, but acetic 
acid renders them fibrillary and punctated. As they have no signification, 
care must be taken not to confound them with the hyaline casts. 

b. Hyaline or Transparent Casts. These are very rare in normal urine, and 
the presence of a large quantity- of them in the sediment, is a certain indica- 
tion of albuminous nephritis. They are distinguished from the preceding by 
having well defined margins, delineated by a distinct line. They are straight, 
or spirally twisted, with parallel borders, and are formed of a homogeneous 
transparent matter of proteinous nature. Their extremities are marked by 
a clear and distinct fracture, and they often present transverse slits at points 
along their longitudinal surfaces. Acetic acid difficultly attacks them. 
Iodine solution, or solution of carmine colors them, but a great deal better if 
the disease is of long standing; in this case, they have naturally a yellowish 
reflection. Finally, they often have some epithelial cells upon their surface, 
from the renal tubules, generally granular, and which sometimes form a 
complete cortex to the cast; this is especially observed in an advanced stage 
of albuminous nephritis. We may have all the varieties in one sediment. 

A hyaline cast, of more solid aspect, is termed a waxy cast, and as these 
cylinders have none of the physical or chemical characters of fibrin, it is an 
error to call them fibrinous. By the term hyaline, nothing concerning their 
composition is prejudged, while it recalls to mind an important physical 
character. 

c. Epithelial or Granular Casts. These are the internal casts, derived from 
the renal tubules, the epithelium of which is often altered, granular, and 
infiltrated with proteinous granulations, or with fatty droplets. These casts 
are usually wide, never very narrow. When the granular aspect of a cast is 
of a dark, somewhat solid character, it is termed a "granular cast." The 
"fatty, or oil cast" is a variety of the granular, produced by the granules of 
olein running together into globules of fat. Epithelial cells, blood corpus- 



KEN 169 REN 

cles, leucocytes, pus corpuscles, urates, uric acid and especially oxalate of 
lime crystals are often observed in these casts. When blood corpuscles exist 
in these cylinders they are termed " blood casts." 

d. Fibrinous Casts. These are casts composed of a finely granular matter 
which swell and become clearer under the action of acetic acid, and which 
contain blood corpuscles in their interior. They indicate a hemorrhage, the 
rupture of some capillary vessels, or an effusion of blood in the interior of 
the uriniferous tubules. 

All these casts may be colored by the bile when there is an icteric compli- 
cation, or they may be interspersed with granulations of urates, or with 
crystals, which may be cleared away by a drop of acetic acid. — With the 
exception of the hyaline, these casts have often been observed in sediments 
of non-albuminous urine, as, in certain forms of purulent infection, in icterus 
consecutive to an attempt at asphyxia by charcoal, and which appear to be 
owing to a state of renal congestion. 

Clinical Import. See Albumen. "The presence of casts in the urine is a 
sure sign of disease of the kidney, but not, however, necessarily of a permanent 
disease. They are present in many acute diseases accompanied by more or 
less albumen in the urine, as, in bronchitis, pneumonia, convalescence from 
scarlatina, etc. But if they are found for several weeks together, after all 
pyrexia has subsided, permanent disease of the kidney may be inferred. 
Casts are constantly present in the urine in all cases of renal congestion, and 
of acute or chronic Bright's disease. But no certain information as to the 
nature of the renal disease, that is, whether lardaceous or fatty, can be 
obtained from the characters of the casts, since all forms of Bright's disease 
terminate in fatty changes. Some assistance, may, however, be derived from 
the appearance of the casts in forming a judgment of the acute or chronic 
character, or, a prognosis, of the disease. If, for example, there be found in 
the urine any epithelial casts which have undergone little, or no, granular 
change, and also casts studded with red-blood corpuscles, together with a 
large quantity of epithelium from the renal tubules, having a natural or only 
slightly cloudy appearance, there can be little doubt that the patient is suf- 
fering from an acute attack of Bright's disease ; while if the casts be chiefly 
fatty, or intensely granular, and the epithelium be small in amount, and the 
cells withered and contracted, or containing globules of olein, it will be more 
than probable that the case is one of chronic Bright's disease. — Since little 
reliance can be placed on the characters of the casts as an aid to special diag- 
nosis, some of the renal derivatives in the chief forms of kidney affection 
have been subjoined. 

" Congestion of the Kidney. The casts are chiefly hyaline, seldom showing 
any marks of fatty change. Very rarely are blood or epithelial casts dis- 
covered. — Acute Bright's Disease. At the commencement, the urine deposits 
a sediment which consists of blood corpuscles, narrow hyaline casts, and casts 
covered with blood corpuscles, the 'blood casts' of some authors. In the 
next stage, the amount of blood present is not so great, but a considerable 



RES 170 KOS 

desquamation of the renal tubules taking place, renal epithelium and epithe- 
lial casts are found in great numbers ; the epithelium has undergone very 
little, if any, granular change; hyaline casts are observed together with epi- 
thelial. In the next stage, the changes in the epithelium may be almost 
daily observed ; at first, they become granular, cloudy in appearance, which 
alteration (the sequel of the catarrh) often proceeds to fatty degeneration, 
and the epithelial cells then contain large fat drops, while the epithelial 
casts undergo similar change, and become distinctly granular and even fatty. 
If the patient recover, the casts and epithelium gradually disappear from 
the urine ; but if the case becomes chronic, the renal derivatives show the 
characters described in the next paragraph. 

" Chronic Bright' 's Disease. Numerous forms of casts are met with ; the 
hyaline, both narrow and wide forms; the larger are often beset with gran- 
ules which dissolve on addition of acetic acid; the granular, whose surface 
is often covered with fatty or shriveled up epithelial cells ; fat drops may 
stud the cylinder. Epithelial casts are rare, except in febrile exacerbations, 
when the renal derivatives found in acute Bright' s disease are present, together 
with granular and fatty casts, evidence of the previous alteration of the 
kidney. — Lardaceous or Albuminoid Kidney. The urinary deposit contains 
hyaline casts, which are often accompanied by pus corpuscles. Atrophied 
epithelial cells, becoming fatty in the later stages of the disease, are almost 
invariably present." W. Legg. 

Resins. Resins administered internally affect the urine variously, while 
some have no influence whatever, others develop peculiar odors, while a third 
portion affects the color of this fluid. These investigations are, however, of 
an imperfect and limited character. The greyish-yellow color imparted to 
urine by resin, is converted into blue by the action of perchloride of iron. 
Gamboge, taken in large quantity, colors the urine yellow. Aloes imparts a 
deep-red color, etc. In many instances the odor or the color does not depend 
upon the resin itself, but upon a peculiar acid or other principle associated 
with it ; thus, it appears to be the resinous acid of copaiba that influences 
the urine. See Color of Urine. Odor of Urine. 

Rhubarb. According to the degree of acidity or alkalinity of urine, its 
color assumes a greenish, or more or less deep yellow color, when rhubarb has 
been taken internally ; the addition of ammonia or potassa to the fluid, 
changes the color to a fine blood red. 

Rosacic Acid, A name that has been applied to neutral urate of soda, 
likewise, to the coloring matter found in the roseate sediments of urine. As 
these sediments contained a peculiar acid, Proust termed it rosacic acid, but 
subsequently found the acid to be merely uric acid and a red coloring sub- 
stance. This coloring substance is now considered to be one of the modifica- 
tions of urohematin. 



SAB 171 SAB 



s. 

Sabulous. Like sand, as, sabulous urine, gritty or sandy urine. 

Saccharomyces Cerevisise. A fungus growth supposed to exist only in 
saccharine fluids, and to be distinct from torula cerevisice, with which it has 
generally been associated. It consists of numerous round or ovoid, granular, 
brownish bodies or cells, presenting one or several distinct, clear, granulated, 
or dark, nuclei. These cells, during the process of budding, will present an 
appearance, as if two, three, or more, were united in irregular forms. If an 
aqueous solution of a small quantity of honey and white of egg, be kept for 
12 or 15 hours at a temperature of from 96° to 105° F., these bodies appear, 
and may be studied under the microscope, in their various stages. 

Salicin. According to Landerer and Ranke, this agent, when taken in 
considerable doses, partly passes away in the urine unchanged ; the remainder 
undergoes changes similar to those effected artificially by oxidizing agents. 
The changes are supposed to be from salicin to saligenin, saliretin, salicylous 
acid, salicylic acid, and carbolic acid ; the first two have not been detected in 
the urine, but the remainder have. Bertagnini found salicyluric acid in the 
urine, supposed to be formed by the combination of salicylic acid and glyco- 
coll, somewhat similar to the manner in which hippuric acid is formed by 
the combination of benzoic acid and glycocoll. — As with salicylic acid, sali- 
cin, when passed in the urine (salicyl hydride), forms a purple-red color with 
perchloride of iron. 

Salicylic Acid. This agent when taken internally is rapidly eliminated 
by urine; on this account it should be administered in small doses frequently 
repeated. A few drops of urine, from a person who has taken salicylic acid, 
added to a small portion of a very dilute solution of perchloride of iron, 
will occasion a precipitate of a beautiful intense violent color, indicative of 
the presence of this acid. Prof. See. If the urine be high colored, previous 
to applying the above test, an excess of acetate of lead should be added to 
throw down the coloring matters; then filter, and to the filtered liquid care- 
fully add an excess of sulphuric acid, which will precipitate the lead. Fil- 
ter again ; and to the resulting clear liquid, add a few drops of the test, as 
above. 

Sand. See Gravel. 

Santonin. Santonic Acid. Passes quickly in the urine, to which it im- 
parts an orange-yellow color. This yellow color is converted into a deep 
red when an alkali is added to the urine (or when the urine itself is alka- 
line) ; liquor potassa giving the best results. Rhubarb produces similar re- 
sults, but crystals of oxalate of lime will likewise be found in the urine, 
which is not the case when santonin is given, unless these crystals previously 
existed, pathologically, in this liquid. 

Sarcinie. Sarcina ventriculi is a fungus discovered by Goodsir, in the 



SAK 172 SOD 

matters ejected from the stomach, under certain conditions. A number of 
minute greenish cells, roundish or square, are aggregated together in series 
of 4, 8, 16, 32, 64, etc., forming a large cube. A similar fungus has been 
found in the pelvis of the kidney, by Hepwood ; and Beale, Begbie, Johnson, 
Heller, Munck, Welcker, and others, have found it occasionally in the urine. 
The cells of the urinary sarcina are smaller, and less regularly arranged than 
those from the stomach and lung, and frequently have a darkly punctated 
center. Their clinical import is unknown ; many regard them as mere acci- 
dental formations. They are found in acid, neutral, -or alkaline urine, more 
commonly the last, as, in vesical catarrh, painful urination, renal pains, also, 
during the presence of dyspepsia, hypochondria, etc. The urinary fungus 
has been termed merismopoedia punctata (Meyen), and Sarcina "Welckeri 
[Rossmann). See Fungi. Vegetable Organisms. 

Sarkine. Sarcine. See Hypoxanthin. 

Sediments. See Urinary /Sediments. 

Senna. Senna taken internally imparts a brownish color to the urine, or, 
according to Gubler, an intense yellow with greenish reflection, similar to 
icteric urine; but the characteristic reaction of the coloring matters of bile 
by nitric acid, does not exist. Moreover, if a fragment of caustic potassa, or 
a drop or two of ammonia, be allowed to fall to the bottom of a tube con- 
taining senna-colored urine, a beautiful purple color is formed, which is not 
the case when the color of the urine is due to bile matter. Prof. Hirtz 
states that the biliform color produced by senna only occurs in neutral urine, 
and when the urine becomes alkaline the red color is established; if a drop 
of nitric acid be added to a small quantity of the urine, the red color in- 
stantly disappears. Gubler intimates that these reactions are owing to ohry- 
sophanic acid in the senna, as, similar, but less marked, reactions occur with 
rhubarb. 

Silica. Si 3 . Silicic Acid. Oxide of Silicon. This substance is found in 
various parts of the body, as, in the blood, muscles, hair, bile, etc. It is also 
met with in minute quantity in the urine, and has formed a small element 
in the formation of biliary and urinary calculi. It is chiefly derived from 
plants belonging to the ceralia, as, wheat, rye, etc., which are rich with silica. 
It has never been found as a deposit in urine, except when placed there for 
purposes of deception. It may be obtained by evaporating a large quantity 
of the urine containing it, to dryness, and reducing the residue to an ash by 
calcination. The silica will be found in the ash, if present at all; it is 
insoluble in water and acids, but entirely soluble in boiling liquor potassa, 
or soda, and in hydrofluoric acid. 

Silk. Fibres of silk are sometimes observed in urine ; they are of small 
diameter, of regular size, have a clear outline, and a smooth, shining aspect, 
and bear no resemblance to renal casts. They swell in nitric acid, and are 
readily soluble in liquor potassa or soda ; in solution of neutral chloride 
of zinc. 

Soda, Carbonate of. See Carbonate of Soda. 



SOD 173 SOL 

Sod:t, Phosphate of. See Phosphate of Soda. — Phosphate of Soda, Ammo- 
niacal Solution of Take of pure phosphate of soda 1, distilled water 10 ; mix, 
and when dissolved, add ammonia 2. Label, " Ammonial Solution of Phosphate 
of Soda. Detection of Magnesia." 

1. Soda, Solution of. Take of caustic soda 1, distilled water 10 ; mix. 
Label, " Solution of Soda at the joth." — Solution of Caustic Soda, sp. gr. 1.12, may- 
be procured by treating the caustic soda ley (of soap boilers) of 36° Baume, 
(1.33-1 with the densimetre), 240 grammes, with distilled water 360 grammes. 
A total volume of 600 grammes of sp. gr. 1.12, is obtained, containing about 
80 grammes of soda in the solution. — 2. Standard Solution of Soda. For Analysis 
of Ammonia. Into a small beaker glass place 10 c. c. of the standard solution 
of sulphuric acid (for analysis of ammonia), and add to it a few drops of tinc- 
ture of litmus until the solution is rendered slightly red. To this add, from 
a graduated burette, a carefully prepared dilute alcoholic solution of freshly 
made soda, free from carbonic acid, until the blue color of the litmus is 
restored. Then read off upon the burette the amount of this caustic soda 
solution required to neutralize the 10 c c. of the solution of sulphuric acid. 
Suppose 30 c. c. of the soda solution have been required, then we know that 
every cubic centimetre corresponds with .00715 gramme of ammonia, as the 
10 c. c of standard solution of sulphuric acid, neutralized by 30 c. c. of the 

soda solution, correspond to 0.2146 gramme of ammonia, '~* =.00715 

gramme. — 3. Standard Solution of Soda. For Analysis of Lime. Place 10 c. c. 
of the standard solution of hydrochloric acid (for analysis of lime) into a beaker 
glass, and add a few drops of tincture of litmus until it is slightly reddened. 
To this add, from a graduated burette, a solution of freshly made soda, per- 
fectly free from carbonic acid, until the blue color of the litmus is restored. 
Then read off upon the burette the amount of this soda solution required to 
neutralize the 10 c. c. of hydrochloric acid solution. The soda solution must 
be of a strength that 10 c. c. of it will accurately neutralize 10 c. c. of the 
standard solution of hydrochloric acid. Suppose, in the process just given, 
8 c. c. of the soda solution were required to neutralize the acid solution, we 
then measure off 800 c. c. of the soda solution, and add enough distilled water 
(200 c. c.) to make exactly one litre. (Or, if 6 c. c. of the soda solution were 
required, we measure off 600 c. c. of this solution, and dilute to a litre with 
400 c. c. of water.) Equal volumes of the hydrochloric acid, and the soda 
solution, will now exactly neutralize each other. 

Soda, Urate of. See Urate of Soda. 

Solids in Urine. The solids in urine comprise the brown, strongly odor- 
ous, and bitter residue remaining after the fluid portion of the urine has been 
removed by evaporation, and which is composed of organic and inorganic 
acids and bases. See Fig. 34. The amount of solids passed in the urine of 
24 hours by a healthy person varies from 40 to 66 grammes, depending upon 
certain physiological (as well as pathological) conditions, and, owing to 
which, the urine, even of the same person, may contain at different periods^ 



SOL 174 SOL 

different quantities of solids. Diet, exerts an influence in this respect, the 
solids being augmented by an animal diet, lessened by a vegetable, and still 
further diminished by a non-nitrogen ized diet; while a mixed diet gives a 
medium amount. When large amounts of water are taken into the stomach, 
the solids are usually increased in the urine of 24 hours. Males excrete 
more solids than females. It will likewise be found that the solids are 
increased in certain diseases, and reduced in others ; also, that the daily 
amount of solids is influenced by the internal use of fermented or alcoholic 
drinks, as well as of certain medicines, and by sedentary or active habits of 
mind and body. A persistent increase in the urinary solids is an unfavor- 
able symptom, indicating an excessive destruction of the constituents of the 
body, tending to exhaustion and ultimate wasting of the tissues; while a per- 
sistent decrease, indicates a diminution of vitality tending to fatality. How- 
ever, it would be extremely improper to form a conclusion from the amount 
of solids only; the quantity of fluid, the sp. gr. of the urine, and the nature 
of the solids must all be taken into account. When urea, the principal solid 
constituent of urine is retained, the urine does not increase in quantity, 
though it may diminish, and its sp. gr. is low, as, in uremia. In most chronic 
diseases, except diabetes, in which the solids are reduced, we may augur 
favorably when they become increased ; while, in acute diseases, an increase 
of the urinary solids, is an unfavorable indication. See Agents, etc.; Specific 
Gravity; Urinorneter. 

t An approximate determination of the amount of solids existing in the 
mixed urine of 24 hours may be made in a few minutes, and with sufficient 
accuracy for ordinary clinical purposes by using Trapp's formula 2, or Hasser's 
(diabetic urine) 2.33. Thus, having determined the correct sp. gr. of the urine, 
multiply the last two figures of the number expressing this sp. gr. by 2.33, 
and the result gives the amount of solids, in grammes, existing in 1,000 c. c. 
of the urine. For instance, a person passes 1,250 c c. of urine in 24 hours 
of sp. gr. 1.020. The last two figures (20) of this sp. gr., being multiplied by 
2.33. gives 46.6, which is the amount in grammes of solid matters contained 
in 1,000 c. c. of the urine. But 1,250 c. c, were passed in the 24 hours, 
and a little calculation will be required to determine the solids in this 
quantity, which consists in simply multiplying the whole amount of urine 
passed in 24 hours (1,250) by the amount of solids in 1,000 c. c. of the urine 

(46.6), and then dividing this by 1 ,000 ; thus, ' ° 0Q0 = 58.25 grammes. 

And so with any amount of urine in 24 hours, whether it exceeds or falls 
short of 1,000 c. c. Thudicum believes Trapp's formula, which is used in 
the same manner as above described, to be best suited for urine of low sp. gr., 
or below 1.018 ; and Hseser's for urine above 1.018, or of high sp. gr. 

The above method, however useful it may be for ordinary clinical purposes, 
is by no means accurate enough for scientific purposes, which require another 
process involving more or less difficulty, great care, and expenditure of time; 
and, from the disgusting odor emitted during the process, it must be con- 



SOL 175 SPE 

ducted in some out of the way place, or in a properly arranged and well-ven- 
tilated laboratory. Among the several methods that have been pursued, that 
advised by Rose, is probably the quickest and best: Into a clean porcelain 
or platinum crucible of known weight, measure exactly 20 c c. of the urine, 
and gradually evaporate it until it is nearly dry. As heat decomposes a 
certain amount of urea, this may be limited to a minimum by keeping the 
urine constantly acid. Into the nearly dry mass, place some finely ground 
platinum sponge, of known weight (1 or 2 grms.), and stir it around by means 
of a platinum wire, and then continue the evaporation to full dryness. Let 
the crucible remain for some time in an air bath, or under an air pump, and 
then weigh it. From the gross weight, deduct the weight of the crucible and 
of the platinum sponge, and the remainder will be the total amount of solids 
in the 20 c. c. of urine, from which can be calculated the amount in any given 
quantity of the same urine. To determine the fixed inorganic salts, the crucible 
should be placed over a spirit lan%p, igniting the mass in it, and continuing 
the heat until all the carbon is consumed, and a perfectly white ash remains. 
When the crucible is cool, again weigh it, and from the gross weight deduct 
the weight of the crucible and of the platinum sponge, and the amount of 
fixed salts in the 20 c. of urine is obtained. 

Solidarity. The mutual responsibility existing between two or more per- 
sons, or parts; consolidation ; joint interest ; a kind of mutual dependence. 

Sorrel. This plant when taken internally gives rise to considerable oxa- 
alate of lime in the urine. Gallois states, however, that if the sorrel be used 
for a long time continuously, this effect diminishes, or ceases entirely. 

Specific Gravity. The specific gravity or density of urine is more gen- 
erally determined by a small instrument called urinometer. A portion of the 
mixed urine of 24 hours is placed in a small cylindrical glass vessel, into 
which fluid the urinometer is introduced, and as soon as this becomes station- 
ary, the specific gravity is read off. The vessel should be of sufficient length 
so that the urinometer when suspended in the fluid will not touch the bottom ; 
and its diameter should be large enough to prevent the urinometer from 
touching the sides of the vessel, which would interfere with the correctness 
of the result. The above-named method only gives approximative results, but 
which are considered sufficiently accurate for clinical purposes. See Urin- 
ometer. But when great accuracy is desired for scientific research, another 
course is pursued, requiring more time and careful attention. A bottle accu- 
rately adjusted so as to hold exactly 20 c. c. of distilled water, and furnished 
with an elongated ground glass stopper, within which a thermometer is fitted 
(termed a pyenometer) , is employed for this purpose. The weight of the pyc- 
nometer must be known, as well as the weight of the distilled water which 
will fill it. The weight of the urine is determined by carefully filling the 
instrument with this fluid, weighing it, and from the gross weight deducting 
the weight of the empty pyenometer. Then the specific gravity is obtained 
by calculation : As the weight of water is to the weight of urine, so is the 



SPE 176 SPE 

specific gravity of water to the specific gravity of urine. The sp. gr. of water 
is 1. See Pycnometer. 

The indications furnished by the sp. gr. of the urine enables one to calcu- 
late the quantity of solid materials (urea chiefly) contained in this fluid ; and 
the daily variations in the excretions of these matters may thus be observed 
and recorded. These solid matters in the urine are daily modified by the 
food ingested ; thus, soup greatly increases the sp. gr. of the urine. A litre 
of soup will add nearly 15 grammes of solid matter to the urine ; and ii 
tannin be added, an abundant precipitate of gelatin, of modified albumen, 
and other organic substances, is obtained. In order that the physician may 
derive satisfactory information concerning the metamorphoses of the organ- 
ism, from the sp. gr. of the urine, it is highly necessary that all these ali- 
mentary influences be well determined ; and these physiological variations 
can be studied without much trouble. The corrections for temperature must 
not be neglected, or errors may be made amounting to 4 or 6 grammes oi 
residue per litre. — A considerable and permanent increase of the sp. gr. of 
the urine, should attract attention ; it may be due to an increased amount of 
urea, or to an abnormal secretion of sugar. — A diminution of the sp. gr., co- 
inciding with an increase of the quantity of urine eliminated in 24 hours, is 
met with in certain cases of dropsy, etc. — A diminution of the sp. gr., with a 
decrease in the amount of urine, indicates an obstacle to the secretion of 
urea, and frequently an alteration of the kidneys, as observed in the chronic 
form of Bright's disease. — If the sp. gr. in polyuria be high, it reveals a true 
diabetes ; if, on the contrary, it is low, it represents a false diabetes. See 
Solids in the Urine. 

The average sp. gr. of healthy urine of 24 hours is from 1.015 to 1.0120. 
That which is passed after drinking much water or fluid, from 1.003 to 1.009, 
is generally pale, and is termed urina potus; that which is passed after the 
digestion of a full meal, urina ehyli, has a sp. gr. of 1.030 ; and that which is 
passed after a night's rest, urina sanguinis, furnishes the best specimen of the 
average density of the whole urine, varying from 1.015 to 1.025. However, 
as heretofore remarked, various circumstances may cause the sp. gr. to vary. 
Although the sp. gr. does not yield direct indications of disease, still it fur- 
nishes important information ; thus, a persistently concentrated urine of sp. 
gr., below 1.015, would lead to an examination for albumen, — if still lower, 
1.005 to 1 008, there may have been an hysterical attack, or diabetes insipidus 
may exist. A pale, apparently dilute urine, of sp. gr. 1.025, may be due to 
sugar, most certainly so if the sp. gr. ranges between 1.035 and 1.065. 

Prof. Haughton states that with urine of persons in health or in disease, 
but containing neither sugar nor albumen, the quantity of urea may be deter- 
mined by simply subtracting 1,000 from the sp. gr., and then multiplying the 
remainder by 10. The product will be the number of grains of urea in a 
pint of the urine. In 19 cases, the averages have varied only from 149 to 
156 grains, which, in practice, is of slight importance. — As simple an opera- 
tion is used for determining the amount of sugar; instead of multiplying the 



SPE 



177 



SPE 



remainder by 10, as in the preceding case, multiply by 20, and the solution 
is given. In 16 experiments the averages did not differ 2 grains. 

The following Table has been given for the determination of the propor- 
tion of solid extract in any quantity of diabetic urine, by its specific gravity, 
this sp. gr. being compared with 1,000 parts of water at 60° F. 



XII. Table. 





Grains of Solid Ex- 




Grains of Solid Ex- 


Specific Gravity. 


tract in a Wine Pint 


Specific Gravity. 


tract in a Wine Pint 




of Urine 




of Urine. 


1.020 


382.4 


1.036 


689.6 


1.021 


401.6 


1.037 


708.8 


1.022 


420.8 


1.038 


728.0 


1.023 


440.0 


1.039 


747.2 


1.024 


459.2 


1.040 


766.4 


1.025 


478.4 


1.041 


785.6 


1.026 


497.6 


1.042 


804 8 


1.027 


516.8 


1043 


824.0 


1.028 


5360 


1.044 


843.2 


1.029 


555.2 


1.045 


862.4 


1.030 


574.4 


1046 


881.6 


1.031 


593.6 


1.047 


900.8 


1.032 


612.8 


1.048 


920.0 


1.033 


632.0 


1.049 


939.2 


1.034 


651.2 


1.050 


958.4 


1.035 


670.4 







(See Table of Corrections for Saccharine TJr 



iz.) 



Spermatozoids. Spermatozoa. Zoosperms. Seminal Filaments. Spermzoons. 
Seminal Animalcules. .See Fig. 31. Spermatozoids can be detected in the 
urine only by means of a microscope; using a low power at first, to rapidly 
pass the suspected deposit under review, should only a few of these be pres- 
ent; and subsequently, a higher power of 350 or 400 diameters, should fila- 
ments resembling spermatozoids have been discovered in the fluid by the low 
power. A power of 500 diameters shows them well. They consist of an 
anterior, flattened pyriform enlargement (the head), and a finely tapering 
filiform appendage (the tail) ; all these parts appearing completely homo- 
geneous and brilliant. Their entire length is about mm .050, the head 
alone measuring about mm .005 in length. At its orgin, the tail measures 
about mm .001 in diameter, from which point it gradually diminishes in 
diameter up to its extremity. In semen these filaments move rapidly 
through this fluid, and in a peculiar, undulating manner. The rapidity of 
movement has been estimated at mm .060 per second, that is, they move in 
a second through the space of a linear quantity nearly equal to their own 
length. The force of projection developed by this undulatory motion is suf- 
ficiently powerful, not only to displace the filament in the midst of the 
medium in which it moves, but even to push and displace many epithelial 
12 



SPE 



178 



SPE 




Fig. 31. cells and crystals larger 

than it, which have formed 
from the evaporation of the 
fluid on the glass slide, and 
against which it strikes in 
the course of its movements. 
As the liquid in which they 
move becomes condensed 
by evaporation, phosphatic 
crystals form in the field of 
the microscope, the motions 
of the spermatozoa become 
less and less active, and 
when motion is about to 
cease, they fold themselves 
so as to form a loop, or kind 
of ring; but they are not 
dead, as an alkaline solution 
will, even after an hour or 
two, restore their move- 
ments. — In seminal urine 
may also be detected a few 
minute granular corpuscles, 
of a round or oval form, 
and rather larger than the bodies of the spermzoons, termed "sperma'ic 
granules." Traces of albumen may also be quickly detected in urine, by the 
application of heat and nitric acid; and large octohedra of oxalate of lime 
are of common occurrence. 

Water or acid fluids added to semen arrests the movements of the sperma- 
tozoids, and hence, when observed in urine, they are always motionless, unless 
a considerable amount of pus be likewise present. These anatomical ele- 
ments are very easy to recognize, and can not be confounded with others. In 
sedimentary urine, they are found mixed with the deposit, and are very often 
held in some filaments of mucus. In urine, post coitum, they are thus pre- 
sented. A remarkable character is their decided resistance to nearly all 
causes of destruction. They have been found in putrefied urine at the ter- 
mination of three months. Mineral acids and caustic alkalies attack them 
only when heated. Acetic acid effects no change in them, except to render 
them more conspicuous. After drying and softening in water, they preserve 
a recognizable and perfectly characteristic form, which is of great importance 
in medico-legal examinations. According to Valentin, calcination itself 
leaves their form intact. Ammonia, however, rapidly acts upon them, even 
when cold. Solution of carmine, iodine water, etc., which color leucocytes 
and epithelia, have no action on spermatozoa. In cases where they are 
mixed with certain deposits, so as to interfere with their detection, these de- 



A. Torula cerevisise, found in urine after it has under- 

gone saccharine fermentation. 

B. Penicilium glaucum, a fungus growth in acid urine 

containing albumen, when exposed to the air. 

C. Seminal animalcules or spermatozoa, and seminal 

granules. 



SPI 179 STA 

posits may be removed and the field of the microscope be cleared up, by the 
addition of a little acetic acid, if phosphates be present ; and, if urates, by a 
solution of soda, or of potassa, at the T Vth. 

Clinical Import. The presence of spermatozoids in the vaginal mucus, or 
upon the linen of a woman, is considered as being proof of coition, or of an 
attempt at it; and their detection, therefore, is of immense importance in 
cases of suspected rape. By soaking a piece of muslin or linen, which has a 
stain upon it, in some water for an hour or so, and then examining the sedi- 
ment in the water, these filaments, when present, can readily be detected. 
Spermatozoids are frequently found in the urine of males who are in a state 
of health. But when they are observed more or less constantly in the urine, 
accompanied with other more important symptoms, they demand interference. 
Frequently, their presence signifies masturbation, and thus may be revealed 
to the physician unacknowledged habits which he can only suspect. They 
are met with in urine after coition, as well as after nocturnal pollutions; 
they have been observed in the urine of patients laboring under typhus, and 
under the badly defined disease, known as involuntary losses, or spermator- 
rhea ; in severe cases of this last named malady, they may be broken, imper- 
fect, and deformed. A few spermatozoids in the urine, requiring great care 
and delicacy to collect for examination, are of no clinical importance 
whatever. 

Spirillum. Small, short filaments of corkscrew form, moving rapidly by 
a very remarkable spiral or gimlet-like motion. They are insoluble in boil- 
ing potassa. They vary in size from T ^ -g-th to g^o^ 1 of an i nc ^ i n length, and 
from 2 ooo th to T2¥o o^ °^ an mcn m diameter. See Vegetable Organisms. 

Stains, to Remove. Nitrate of Silver. Take of cyanide of potassium 10 
grammes, distilled water 125 grammes; mix. At the time of using this, add 
tincture of iodine 20 drops, or, in proportion to the amount of solution 
employed. Place a few drops of this mixture on the spot, and gently rub the 
moist spot with the fingers; then wash with soft water. The operation should 
be performed in a darkened place, as a bright light destroys one of the princi- 
pal agents, the iodide of cyanogen. It must be remembered that in presence 
of acids the cyanide of potassium disengages prussic acid, and that any reac- 
tion of this kind must be avoided, or serious results may occur. — 2. Dissolve 
half a grain or a grain of iodine in 10 or 15 drops of ammonia, then, by 
means of a brush, apply some of the solution to the stains ; after the stains 
disappear, wash with water. Throw away the solution when done with it, 
because when dry it forms the explosive iodide of nitrogen. This is a prompt 
procedure, free from the danger attending the use of cyanide of potassium. 
Nitric Acid. When the spots are fresh, wash them repeatedly with a con- 
centrated solution of permanganate of potassa, and then wash with water. 
Remove the brown stain produced by the permanganate, by an aqueous solu- 
tion of sulphurous acid. Old stains, from nitric acid, will only disappear 
with the epidermis. — Picric Acid, likewise stains the skin yellow, and which 
may be removed by repeated washings. 



STA 180 STE 

Stanhope Lens. A kind of toy, consisting of a thick double-convex 
lens, one surface of which is of greater convexity than the other. The object 
is placed upon the least convex surface of the lens, while the eye is applied 
to the greater convex surface. When the least convex surface is applied to 
the eye, the lens forms a simple microscope having a focus of one-fourth to 
one- eighth of an inch. See Coddington Lens. 

Starch Granules. These are frequently found in urinary sediments, 
having entered them accidentally, or intentionally for purposes of deception. 
They may be detected by boiling them in a test tube with water, when they 
swell and become changed into a jelly-like mass. Tincture of iodine, or 
solution of iodine causes them to assume a blue color. Under the micro- 
scope they present the following appearances: — Potato starch, the granules are 
ovate or egg-shaped, and the hilum or point around which a number of con- 
centric lines are arranged, is situated near one extremity. Wheat starch, the 
grains are circular, with a central hilum which is seldom visible. Mice starch, 
granules very minute and of irregular form. — In bread crumbs 1;he starch 
granules, although preserving their general form, are much swollen, trans- 
parent, and sometimes appearing as if cracked. 

Strangury. Difficult urination, attended with tenesmus, pain, and a 
sensation of scalding, as the urine passes drop by drop. 

Strychnia. When taken internally, strychnia passes off by the urine, but 
whether all that is swallowed is eliminated through this fluid is not positively 
known. Strychnia crystallizes in octohedrons with .rectangular base, or in 
quadrilateral prisms, terminated by pyramids with four faces ; it is soluble 
in alcohol and benzine, insoluble in ether, fat oils, and liquor potassa. Its 
alcoholic solution turns the plane of polarization to the left. Chloride of 
gold precipitates it from its solutions in fine crystals ; if to the isolated crys- 
talline precipitate, a few drops of concentrated sulphuric acid be added, or 
enough to dissolve it, and then a very dilute solution of chromic acid be 
gradually added by drops, a beautiful blue color will be produced. If too 
much chromic acid be added the color will disappear. Alcohol must be 
absent from the solution tested. Strychnia may be detected in the urine by 
one of the following methods: — 1. See Morphia, Erdmann's process, No. 5. 
By this process, if strychnia only be present in the urine, no coloration will 
be produced, after the addition of the mixture of sulphuric and nitric acids 
and the 2 or 3 drops of water. But after a few fragments of binoxide of man- 
ganese, have been added, a purple-violet tint changing to deep onion red, will 
indicate the presence of strychnia'; and then, if the distilled water and ammo- 
nia be added, the violet purple changes to a yellowish green and yellow. — 2. 
Remove any albumen that may be present; add subacetate of lead, filter, 
and treat the filtered urine by sulphureted hydrogen to remove the lead. 
Again filter, and evaporate the remaining liquid to dryness; place the residue 
in contact with ammonia, for 24 hours, then agitate with double its weight of 
chloroform, and again evaporate. Dissolve the residue in 2 c. c. of water 
acidulated with pure nitric acid ; filter, place the liquid in a watch glass, and 



SUC 181 SUG 

add a drop or two of solution of bichromate of potassa. After several days crys- 
tals of chromate of strychnia will be deposited, visible to the naked eye, from 
which the chemical characters of strychnia may be recognized. By this pro- 
cess the sTrVusth P art °f strychnia has been detected. Cloetta. — 3. Saturate 
the suspected urine with ammonia, and allow it to evaporate spontaneously; 
heat the residue with a little amylic alcohol, and then add a few drops of this 
solution to .sulphuric acid and bichromate of potassa; if strychnia be present, 
a blue color will be produced. Schachtrupp. — 4. Acidulate the urine with 
concentrated sulphuric acid (after having removed albumen and precipitates), 
and then add a small quantity of sesquioxide of cerium ; on agitating, a 
beautiful blue color will be produced if strychnia be present, which gradu- 
ally changes to a cherry red. If brucia be present, the color will be orange 
and then yellow ; morphia, an olive brown, becoming brown ; if narcotine, a 
red brown, becoming a cherry red; if codeia, an olive green and then brown; 
quinia, a pale yellow. Sonneschein. — 5. Dr. R. Southey considers a saturated 
solution of iodic acid as a veiy delicate and exceedingly sensitive test for 
detecting strychnia; he adds some of this reagent to the final chloroform 
extract obtained by Sta's method (which it is not necessary to give here) ; if 
strychnia be present, a pink-rose color is produced, which, after some time, 
fades gradually to a fawn color. In Cloetta's method (2) above named, iodic 
acid may be used instead of the solution of bichromate of potassa. 

Succinic Acid. There is uncertainty with regard to this acid in the 
urine. Kletinsky states that when he took a succinnate he found this acid 
in the urine ; Buckheim, and Hallwachs, could not detect it in the urine, 
even when large quantities of a succinate were taken internally. Wohler, 
Meissner, Koch, and Salkowski have found this acid in dog's urine ; the first 
named, also in that of the wolf. 

Sugar. Grape Sugar. Glucose. This is an abnormal ingredient of urine. 
When present, the urine is apt to be paler than natural, clear, and having a 
greenish tint, unless urates or phosphates are present. Its taste is sweet, and 
its odor faintly agreeable, like that of new-mown hay, and it readily ferments. 
On pouring the urine from one glass into another, it will froth readily. Its 
sp. gr. varies from 1.025 to 1.055, depending upon the conditions present; 
thus, an excess of urea may increase its sp. gr., while the presence of albumen 
may greatly diminish it. After testing the urine for albumen, the next step 
should always be to determine whether sugar be present, more especially in 
cases where the symptoms would lead to a suspicion of its presence. Before 
undertaking the analysis, any albumen in the urine must be precipitated by 
heat and acetic acid, and then separated by filtration. The presence of albu- 
men interferes with the proper action of the reagents employed. If the urine 
be high colored, from bile pigment or otherwise, it may be rendered colorless 
by placing an ounce or two of it in a half-pint bottle, together with a table- 
spoonful of animal charcoal, and 15 or 20 grains of carbonate of soda, and 
then shaking it well for 5 or 10 minutes ; on filtering, the urine will be 
clear. Another method, is, to add a solution of sugar (neutral acetate) of lead, 



SUG 182 SUG 

which precipitates the coloring matters, tannin present, and also a small 
amount of sugar ; this does not interfere with the qualitative analysis. (See 
Tables of Correction of Saccharine Urine in Appendix.) 

Qualitative Analysis. 

The detection of glucose in the urine by Fehling's solution, or any of its 
modifications, rests upon the fact that the salts of copper (the acetate, sul- 
phate, and tartrate, but not the nitrate) are reduced by glucose in presence 
of a fixed alkali, and which reduction is hastened by the action of heat; a 
red oxide of copper being precipitated. Under certain circumstances, this 
action may be prevented, as, by the presence of ammoniacal salts, or albu- 
minoid matters; or it (the action) may occur when sugar is absent, because 
various organic substances determine it, as, allantoine, chloroform (Beale), 
cellulose, creatine, creatinine, leucin, tannin, — uric acid? (Berlin). There 
is still a minor cause of error, the precipitate of the earthy phosphates of 
the urine under the influence of heat and Fehling's solution, which is alka- 
line. This precipitate is flocculent and greenish, and but little experience is 
required to enable one not to confound it with the reduction of the copper 
salt ; however, it should be avoided if possible. 

We may, at the start, avoid these causes of error, as, heretofore stated, by 
removing the ammoniacal salts and albuminoid matters ; the organic sub- 
stances, referred to, have a much less energetic reducing power than glucose, 
and require a prolonged boiling, which it is easy to avoid, — finally, the pre- 
cipitate of the phosphates is troublesome only when the urine and the alkaline 
liquor are thoroughly mixed, and such mixture can be abstained from. [See 
other causes of error, under Copper, Fehling's Solution, Trommels Test."] The 
following course may be pursued: 

± Preliminary Steps. 

1. The cold urine, filtered or decanted is not albuminous. f See 3. 

2. The cold urine contains albumen . . \ See 5. 

3. The urine has an acid or neutral reaction (diabetic f 

urine is almost always acid) \ See Detection. 

4. The urine has an al- f Boil it in a tube with a small f 
kaline reaction due to am- < piece of caustic soda; filter or < 

moniacal salts. (. decant, and pass to ( See Detection. 

5. Add a few drops of acetic acid to the urine, coagulate 
the albumen by heat and filter. It is useful to neutralize 
the filtered urine with a little carbonate of soda, and then 
test as per I See Detection. 

Remarks. — 3. The alkalinity of the urine should be attended to only in 
case it is ammoniacal, whether this occurs from decomposition after its 
emission, or, is passed by a patient laboring under vesical catarrh. Upon 
boiling it for two or three minutes, a strong ammoniacal odor is given off", 
and at the same time the phosphates are precipitated. "When the odor, just 
referred to, ceases to be evolved, the phosphates should be allowed to precip- 



SUG 183 SUG 

itate, or, the urine may be filtered. — After a great number of trials, this is 
the process upon which we have determined. The presence of the ammoni- 
acal salts in a saccharine urine is a very common cause of error, and one 
quite difficult to overcome. It simply suffices to add a few drops of solution 
of hydrochlorate of ammonia to a strongly saccharine urine, to prevent any 
reaction from occurring, even on prolonging the boiling. 

Now the result of my experience is as follows : If normal urine be boiled 
with a piece of caustic soda or potassa, a flocculent precipitate of phosphates 
will be obtained, and very frequently the liquid will also become darker, 
assuming a more or less brown-amber color. This fact has long been known, 
but it should be constantly present to the mind, otherwise the presence of 
sugar may be erroneously diagnosed. Now, if the liquid be filtered, and the 
clear urine be poured into a tube containing Fehling's blue liquor, a bottle- 
green tint will take the place of the blue. On heating the fluid to boiling the 
tint will become darker, but no remarkable turbidity will appear in the mixture. — 
If an ammoniacal saccharine urine be treated in the same manner, being careful 
to prolong the boiling, and to agitate the tube from time to time until an 
ammoniacal odor can no longer be distinguished, and until a piece of red- 
dened litmus paper placed at the orifice of the tube does not turn blue, — then, 
if the filtered and clear fluid be mixed with Fehling's solution and heated to 
boiling, a precipitate will take place, of a milk and coffee, or chocolate color, the 
abundance of which will be in proportion to the amount of sugar present. — 
AVe are far from guaranteeing the infallibility of this method, which is the 
result of comparative experiments made with urine artificially rendered 
saccharine. It may be observed, however, that this method has enabled us 
to detect the sugar after having previously and fruitlessly attempted to do so 
with the cupric solutions. 

The coloring assumed by urine upon boiling it with caustic soda, when it 
is very deep, is an almost certain sign of the presence of sugar. The ulterior 
precipitate of the cupric oxide has presented very variable colorings, which 
we can not explain. The more common colors are those named above, and 
chestnut brown. — In doubtful cases, a counter experiment may be made, by 
adding the piece of caustic soda to the blue liquor of Fehling, then pouring 
the urine into this, and boiling the whole together. The reduction is effected 
with disengagement of ammonia; if this does not occur, which is often the 
case, add new quantities of the alkali. It frequently happens, that following 
one of these successive additions, the reduction becomes suddenly effected 
with the variable tints heretofore mentioned. — However, it is unnecessary to 
give too much attention to these difficulties, as it is very seldom that an 
ammoniacal urine will require to be examined for the presence of sugar. 

5. — A small amount of albumen does not prevent the detection of sugar; 
and to facilitate the separation of the albumen from the urine, in addition 
to the acetic acid, a few crystals of sulphate of soda may also be added to it. 



SUG 184 SUG 

t Detection. 
(Before proceeding with this, see Preliminary Steps.) 

{ a. The liquor is turbid ; it has become changed 
1 Place 5 c c of an< ^ * s not P ro P er ^ or tne test - Reject it. 
Fehlinc/s or Pa^s So- \ b ' The liquor remains clear. Add the urine by 
lution in a beaker 'glass, "1 P ou ™git along the tube so inclined that the two 
and boil it liquids do not mix together, and the urine forms a 

| layer 1 or 2 centimetres in height above the blue 
[ liquor, and then proceed as in 2, below. 
2. Heat the surface f 
of contact of the two [ 

fluids, gently turning -j Production of an ochreous yellow ring Sugar. 

the test tube between 
the fingers. [ 

Observations. This very practical process is quite sensitive and exact. 
Mehu lauds it highly, and we have become satisfied that it detects very slight 
traces of sugar — 1. It must be understood that it is useless to employ a larger 
quantity of the reagent. Boiling for one minute is sufficient.— 2. When 
there is much sugar, the ochreous ring of cupric oxide appears before the 
liquid commences to boil ; in any case, the boiling having once occurred, 
must not be continued for too long a time in order to avoid the reducing 
action of the organic substances, heretofore referred to. Besides, the reaction 
continues during the cooling, and the coloring becomes more marked. — If the 
yellow ring of cupric oxide be not obtained, it may be affirmed that the 
urine tested contains no glucose, for if by fraud or otherwise, it was sweet- 
ened with ordinary sugar, no reaction would occur. 

Other Methods. — 1. By Potassa. (Moore's Test.) Add to the urine an equal 
volume of freshly made solution of potassa, sp. gr. 1.060 ; agitate so as to mix 
the two, and then carefully heat to boiling the superior portion of the liquid. 
If sugar be present, the heated portion will become colored yellow, then red- 
dish-brown, or even dark purple when the sugar is in excess, while the 
inferior portion will preserve its original color. The presence of albumen in 
the urine does not interfere with this test ; in the others it is necessary to 
remove the albumen at first. The same result is obtained by a solution oi 
caustic soda. Neubauer recommends this test as a confirmative experiment. 
The coloration is due to the production of glucic, and ultimately of melassic, 
acid, which are held in solution. (Add a few drops of nitric acid to this 
brown fluid, the color passes off, and an odor is given off, somewhat resembling 
that of burnt molasses. (Heller.) Causes of Error. Several specimens of non- 
saccharine urine have been met with, which, boiled with caustic potassa, 
acquired quite a dark Madeira-wine color. Besides, the potassa and soda of 
commerce, contain foreign substances that may disturb the reaction, as, a con- 
tamination with lead, from being kept in flint, and not green-glass bottles, or 
from being prepared and evaporated in glazed earthen-ware vessels, etc. — 2 
By Fermentation. Procure a large test tube, 6 or 8 inches in length, and from 
f to 1 inch in diameter, and adapt a cork to its open extremity. — Also, bend 



SUG 185 SUG 

a piece of ordinary glass tubing, syphon-like, so that one arm shall be 8 or 
10 inches long, and the other 4 or 5 inches. — Through the center of the well- 
fitted cork, above referred to, pass the long arm of the bent tube until it 
nearly touches the bottom or closed extremity of the test tube ; the short arm 
remains on the outside of this tube. The instrument is now ready for use. 
Place a small quantity of baker's or brewer's yeast, 3 or 4 c. c, into the test 
tube, which is then to be filled brimful with the urine. Fit the cork tightly into 
the test tube, with the syphon tube attached to it, so that no air remains 
within the test tube. Place the whole in a warm situation, or, the test tube 
may be introduced into a vessel of warm water. If sugar be present, fermen- 
tation will ensue with generation of carbonic acid, which will drive the fluid 
through the syphon so that it escapes from the orifice of the short arm, be- 
neath which a glass may be placed to receive it. This test may be relied upon 
if the process be properly managed, though it does not indicate the kind of 
sugar. — 3. Take a compress of thread or of cotton (an old cotton handker- 
chief will answer), and allow a drop of the urine to fall upon it, which imme- 
diately spreads out. If this part of the cotton be held over some hot coals, 
or near a hot fire, a very distinct chestnut-colored spot is produced, darker 
at the circumference than at the center, the darkness being deeper as the 
amount of sugar is greater, beside which an odor like that of burnt sugar is 
evolved from the darkened spot. This is an easy, sensitive, and readily ap- 
plied process. Goudouin. — 4. Place two flu idrachms of non- albuminous urine, 
and one fluidrachni of liquor potassa (or soda), into a test tube, to which add 
a few grains of ordinary subnitrate of bismuth ; agitate, and boil for a minute 
or two. If sugar be present, a greyish or black precipitate of metallic bis- 
muth will be precipitated on the walls of the tube. Boetger. However, this 
is not a very reliable process, as the reaction sometimes fails with saccharated 
urine ; while, on the other hand, a black precipitate has occurred where no 
sugar existed in the urine. — O. Maschke has recently proposed a modification 
of the above test, which he considers positively reliable. Every trace of 
albumen, or other protein bodies are removed from the urine, by adding to a 
sample of it, £ or \ its volume of solution of tungstate of soda strongly acid- 
ified with acetic acid. When precipitation has ceased, filter, and to the clear 
filtrate add an equal volume of solution of carbonate of soda, and 3 or 4 
grains of subnitrate of bismuth. Eegardless of any coloration produced, the 
mixture is to be thoroughly agitated, and the bismuth be then allowed to depos- 
it; if the subnitrate has now a grey, brown, or black color, alkaline sulphides 
are present, and a new sample of urine must be used. This second specimen of 
urine must be lightly acidulated with acetic acid, a small amount of the sub- 
nitrate of bismuth be then added, and the whole be well shaken. Filter ; then 
remove albumen from the filtered urine by the process above described, add 
the soda solution and the bismuth, and boil. If the urine contains glucose, 
it will assume a brown color, and the subnitrate will be reduced to the greyish 
or blackish metallic bismuth, with, very likely, some undecomposed oxide 
of this metal. Francqui and Vyvere precipitate nitrate of bismuth by 



SUG 186 SUG- 

excess of potassa ; then heat, and add tartaric acid until the precipitate formed 
is dissolved. A few drops of this fluid boiled with diabetic urine gives a 
blackish precipitate of metallic bismuth. — For further qualitative tests, see 
Kletinsky's Cupropotassic Test; Knapp's Test; Maumene's Reagent; Mulder's Test; 
Lime; Rates? s Test; Specific Gravity, though this is unreliable, and should not 
be trusted to alone in determining the amount of sugar present ; Trommer's 
Test. 

Quantitative Analysis. 

The means employed for quantitative analysis may likewise, in most 
instances, be successfully used for the detection or qualitative analysis of 
sugar in the urine. Among these may be named Pavy's test, the best one for 
the physician ; Fehling's test, equally as accurate ; Mitscherlich's polarizer, very 
exact, but an expensive instrument ; and Wayne's analysis. Pavy's and Feh- 
ling's tests are used similarly in quantitative analysis, the former being worked 
in the English system of minims and grains, the latter in the French metric 
system. With Fehling's titrated solution, 20 c. c. are completely decolorized 
by 1 decigramme (100 milligrammes) of glucose. To determine the saccha- 
rine richness of a diabetic urine, it must be ascertained what volume of this 
urine will decolorize 20 c. c. of Fehling's solution, or, which amounts to the 
same, what volume of urine contains 1 decigramme of glucose. 

At first, it is necessary to be certain that the fluid reagent is exactly titrated. 
To this end, some pure glucose is to be dried at 212° F., of which 1 gramme 
is to be dissolved in 200 c. c. of distilled water; of this solution 20 grammes 
contain 1 decigramme of glucose, and should consequently decolorize exactly 
20 c. c. of the blue test fluid. This done, a burette graduated into tenths of 
cubic centimetres, is to be filled with the saccharine solution up to zero. By 
means of a pipette, 20 c. c. of the test fluid (Fehling's), is placed into a beaker 
or other glass vessel, capable of holding at least 150 grammes, and is then 
diluted with distilled water to the volume of about 100 c. c. Heat the vessel 
over a spirit lamp to the boiling point, and then allow the saccharine solution 
in the burette to flow, drop by drop, into the heated blue test fluid. A tur- 
bidity occurs ; the reduced oxide imparts a violaceous color to the liquor, 
which becomes more and more decolorized as the saccharine fluid falls into 
it. By adding to the blue liquor a few grammes of concentrated solution of 
caustic soda, its density is increased, and the precipitation of the cupric oxide 
is facilitated. — Towards the close of the operation, a few seconds must be 
allowed to pass after each drop has fallen into the blue liquor, in order to 
observe whether the decolorization is complete. The better to seize upon the 
exact instant of this complete decolorization, the burette or glass vessel should 
be held between the eye and the window in such a manner that the light 
passes horizontally through it. If the fluid still retains a blue tint, it must 
be heated anew, and another drop of the saccharine solution be allowed to 
fall into it, and so on until the desired effect is produced. With a little prac- 
tice, the operator will be enabled to exactly decolorize the test liquor. If the 
amount of saccharine fluid necessary to exact decolorization has been exceeded, 



SUG 



187 



SUG 



the liquor, above the reduced oxide, assumes a yellow tint, due to the action 
of the alkali upon the glucose in excess, — in which case, the operation must 
be repeated. — If the experiment is exact, the decolorized fluid, filtered at boil- 
ing temperature, will answer to the following conditions: — 1. It will give no 
red precipitate of cupric oxide, when heated with a few drops of the saccha- 
rine solution ; thus proving that the deeolorization is complete, and that no 
reducible oxide of copper remains in solution ; — 2. It will give no red precip- 
itate of cupric oxide, when heated with a few drops of the Fehling's liquor, 
thus showing that an excess of the saccharine solution has been added. — If the 
test solution of Fehling, and the solution of glucose, have been properly pre- 
pared, 20 c. c. of the latter solution (200 divisions of the burette) will decolor- 
ize 20 c. c. of the former; but, if it has required 224 divisions (of the burette) 
of the glucosic solution to decolorize these 20 c c, it is because this quantity 
of the blue liquor corresponds to grm .112 of sugar. Then, in the investi- 
gations of diabetic urine, we must ascertain what volume of this urine is 
required to decolorize 20 c. c. of Fehling's liquor, and the volume found will 
contain grm .112 of glucose. — See Copper, Fehling's Teat. 

Process of Analysis. The standard of the test liquor having been exactly 
determined by the preceding operations, the following course is to be pursued, 
in order to determine the amount of sugar contained in a given volume of 
urine. Having rendered the urine clear by filtration, 10 c. c. of it are to be 
measured into a graduated test glass, and, according as it is more or less rich 
in sugar, its volume is increased to 100 or 200 c. c, by the addition of dis- 
tilled water. (For the purpose of arriving at 
a more perfect titrage, the column of liquid to 
be operated upon should be rather long; to this 
end, it should, if possible, be so arranged that 
100 parts of the fluid contain only 1 part of 
sugar. If a urine contains 105 grms. of sugar 
per litre, or 10 grms .5 per 100, on adding 19 
times its volume of water to it, we will have a 
liquid at -^th, containing J of glucose in about 
100, which will render the appreciation very 
exact. If the urine contains less than 1 of 
sugar to 100, it will be useless to dilute it with 
water.) 

The urine, having been properly diluted with 
water, is poured up to zero, in a burette divided 
into tenths of cubic centimetres; into a glass 
beaker is also placed 20 c c. of the titrated 
liquor of Fehling, to which a few c. c. of con- 
centrated solution of caustic soda is added, and 
then from 80 to 100 grammes of distilled water. 
The fluid in this beaker, by means of a spirit 
lamp, is brought to the boiling point, and then 



Fig. 32. 




Burette Holder and Two 
Burettes. 



SUG 188 SUG 

the contents of the burette (urine) are passed into it, at first by cubic centi- 
metres, and toward the latter part of the process by drops. Toward the 
termination of the operation, an increased attentiveness is required, being 
careful to always keep up ebullition a few seconds, before adding each fresh 
drop of urine, so as to avoid the entrance of an excess of urine. The 
operation should never be interrupted beyond the few seconds necessary, each 
time of letting a drop fall, for the precipitation of the cupric oxide, other- 
wise (the liquid rapidly absorbing the atmospheric oxygen), the red oxide of 
copper returns to the condition of blue cupric oxide, which is redissolved and 
colors the liquor blue. 

Now, to determine the quantity of sugar contained in a litre of urine, calcula- 
tion must be made according to the following formula : 

s = t>oooo v 

n v' 

S. Quantity of sugar per litre. 

t. Standard of the blue liquor, determined beforehand. 

1,000. Number of cubic centimetres in a litre. 

n. Number of cubic centimetres of the burette required to decolorize the 
blue test fluid. 

v. Original volume of the urine tested. 

V. Volume of the urine after being diluted with distilled water. 

Suppose the liquor of Fehling possesses the exact standard 20 c. c. = 1 deci- 
gramme of glucose, and that the original volume of urine 10 c. c. has been 
diluted so as to measure 100 c. c. Likewise, 94 divisions of the burette hold- 
ing this diluted urine are required to completely decolorize the 20 c. c. of the 
blue test liquor. What amount of sugar is contained in a litre of this urine? 
We have t = grm .1 ; n = 9 cc .4 ; V = 100 ; v = 10 ; which gives us 

Q 0.1 X1,000 w 100 ™ oo 

S = ^ X Jq = 106 grms .38. 

The operation may be made with 10 c. c. of Fehling's solution, that is, one 
volume of the blue liquor corresponding to 0.05 centigramme of glucose. 
The results will be the same, and the operation more rapid. 

Fermentation. Roberts has given a simple method for quantitative analysis 
by fermentation ; although less exact than those named above, it may be per- 
formed by those who have not the means ready for conducting the other 
methods. It is as follows :— Into a 12-ounce vial place 4 fluid ounces of 
urine, and a piece of German yeast of the size of a small walnut. Cover 
this with a piece of glass, or cork it loosely, so that the carbonic acid gas 
may escape, and set it in a warm place to ferment. Beside this, place a com- 
panion vial (4 ounces) filled with the same urine, but without any yeast, and 
corked tightly. In about 18 or 24 hours, according to the degree of warmth, 
fermentation is completed. Ascertain .the specific gravity or density of the 
urine in each vial, always at the same temperature ; the difference between 
which shows the "degrees of density lost," each degree lost indicating the 
presence of one grain of sugar in one fluid ounce of the urine. Thus, if the 



SUG 189 sua 

sp. gr. of the unferraented urine be 1.053, and that of the urine after fermen- 
tation he 1.052, the difference between the two sp. gr. is 1, consequently each 
fluid ounce of urine contains 1 grain of sugar. But if the sp. gr. after fer- 
mentation be 1.004, the difference between the two densities is 49, indicating 
49 grains of sugar to each ounce of the urine. Ordinary yeast may be used 
when the German can not be procured. The patient, or some member of his 
family, may make this analysis every day, after having had a lesson or two, 
and report the density lost to the attending physician. German yeast can be 
had of the parties referred to in the early part of this work. 

Remarks. As diabetic urine is not always to be had, and as it is very ad- 
vantageous to be experienced in the management of its tests, normal urine 
may be artificially sweetened with honey, figs, raisins, or other preserved 
fruits, cut into pieces and boiled with the urine ; then filter, and the clear 
fluid is ready for the examination. Or, ordinary cane sugar may be con- 
verted into glucose by placing a small fragment in water acidulated with a 
strong acid (nitric or hydrochloric), then boiling it, and diluting the solution 
with normal urine. Care must be taken to neutralize it with carbonate of 
soda until effervescence is no longer produced. 

Microscopic Examination of Diabetic Urine. Sediments are rarely observed 
in this urine, though phosphates, urates, or uric acid may be found in it. If 
a drop or two of urine rich in sugar be quickly evaporated to dryness on a 
glass slide, rhomboidal crystals, sometimes disposed in arborescent tufts, will 
be seen ; these crystals are, very probably, a combination of sugar and chlo- 
ride of sodium. Gibbs states that when a considerable amount of salts is 
present in diabetic urine, the sugar crystallizes in small circular masses, with 
minute cvstals projecting from the surface, which, when examined on a 
dark ground, resemble lumps of barly sugar. — Diabetic urine when left to 
itself, instead of becoming ammoniacal, becomes very acid, from the presence 
of carbon"^ acid resulting from its fermentation. 

If it be then examined under the microscope, small white corpuscles will 
be seen, which are the true globules of the ferment, and of others which 
differ very little from them, being the spores of another mycoderm, the peni- 
cilium glawwm, which is developed in many sour organic liquids, especially 
milk. Those mycoderms of diabetic urine are in the form of oval and trans- 
parent cellules, with one or two nuclei, with or without nucleoli, sometimes 
constricted in their center, or presenting a pi-olongation like a glove finger. 
In form and development they greatly resemble those of beer yeast. (This 
yeast can be procured at any brewery ; it always contains a certain amount 
of grains of fecula, which must not be confounded with the yeast globules; a 
drop of a solution of iodureted iodide of potassium will reveal them.) If the 
fermentation is advanced, entangled filaments will be observed, resulting from 
the development of the mycoderms. 

Clinical Import— Sugar in the urine interests the medical practitioner only 
Then present in more or less considerable quantity, persisting for a long time 
and uninterruptedly, — in which case the diagnosis is glucosuria, or diabetes 



SUL 190 SUL 

mellitus. If the presence of sugar in the urine be variable, and its amount 
small, the fact is of no especial importance. Recent investigators state that 
sugar in small amount is present in normal urine. Sugar may be present in 
urine as the result of decomposition of uroxanthin; it may also be found after 
the employment of chloral and other anaesthetics, probably from deficient 
pulmonary action during the anaesthetic condition, in which the saccharine 
formation is not prevented or destroyed ; it has likewise been detected during 
convalescence from certain acute maladies, after injuries to the nerve centers, 
from excess of saccharine or amylaceous matters received into the system, 
etc.; but its presence in the urine becomes important only when it persistently 
occurs in an appreciable amount. The exclusive use of ordinary sugar as 
food does not usually occasion saccharine urine, as might be supposed. In 
all cases of glucosuric urine, an examination should be made of the chloride 
of sodium and other salts that may be present. The persistence of sugar in 
the urine in anthrax, and furunculous diseases, uterine ulcers, gangrenous 
affections, certain inflammatory disorders, etc., has been observed by several 
investigators. Glycohemia, with a minimum amount of sugar in the urine, 
is, by some, considered the first or early symptom of diabetes mellitus. 

Sulphates. Sulphates exist in normal urine in small quantity, princi- 
pally those of soda and potassa, very rarely, if at all, that of lime. About 
3 grms .69 (57 grains) of mixed sulphates pass in 24 hours, or from 1 grm 
.62 (25 grains) to 2 grms .72 (45 grains), the soda salt usually preponderating. 
In the examination of urine for sulphates, the same precautions must be 
observed as in that for the detection of phosphates, always operating upon 
clear and non-albuminous urine. As the urinary sulphates are soluble, they 
do not precipitate spontaneously. 

t Detection of Sulphates. 

r 2< r . .. 3. 



i. 

Acidulate the urine 
quite strongly with 
hydrochloric acid, and 
boil. 



A white precipitate indi- 

Drop an excess of , ? 7, • •/ r +i „i 

7 ,. L , I, - 7 r-i cates sulphuric acid oi the al- 

solution of chloride of ba- < , ,. i u + • +i ( 

■ I .. i -v kahne sulphates in the form 

num into the boiling ' s , , , ^ t , , -, 

n ■ j ° I of sulphate of barvta, msol- 

nuid. it- -i * 

I I uble m acids. 

Observations. — 1. The acidulation (20 c. c. of urine with 4 to 6 drops of 
acid) with hydrochloric acid is to prevent the precipitation of the phosphates 
in the form of barium phosphate, which is soluble in acids, while the sul- 
phate is not. It must be borne in mind, however, that concentrated acids 
and concentrated solutions of many salts diminish the sensitiveness of the 
reaction. Fresenius. — Unless the urine be boiled, the resulting sulphate of 
baryta will pass through the pores of the filter on filtering. JBeale. — 3. The 
soda and potassa of the urinary sulphates remain in the fluid in the form of 
chlorides; the phosphoric acid is displaced, and the phosphate of baryta dis- 
solves by means of the hydrochloric acid. The sulphate of baryta precipi- 
tated will be white if the urine contains normal pigment; greenish, if it is 



SUL 191 SUL 

rich in bilil'uivin ; and from a rose to a dark red color, according to the ab- 
normal amount of urohematin present. 

Upon filtering or decanting the urine after all the sulphate of baryta has 
been deposited, an approximative estimation of the amount of phosphoric acid 
present may be made, by adding ammonia, which throws down phosphate of 
baryta. In this case the contact of air must be avoided. — Act according to 
the method indicated for phosphates. 

Clinical, Import. See Sulphuric Acid. 

Sulphur. When sulphur or sulphides are taken internally, they pass off 
by the urine, in part, as, sulphates, or sulphuric acid. The neutral sulphates 
likewise increase the amount of this acid in the urine. Sulphur occasions 
the urine to evolve sulphureted hydrogen. Sulphur exists in the albuminoid 
substances of the system, in blood, bile, saliva, gastric juice, albumen, cys- 
tine, etc. Some kinds of food are quite rich in it, as, peas, beans, lettuce, 
cabbage, eggs, milk, corn, cauliflower, asparagus, turnips, celery, rice, ginger, 
hops, white mustard, flesh, etc., and which increase the urinary sulphates, 
when taken internally. See Sulphuric Acid. When sulphur exists in organic 
matters in not very minute quantity, it may be detected by mixing some of 
the matters with carbonate of soda and starch ; place the mixture on platinum 
foil, and heat it by the blowpipe. The fused mass is then conveyed in a 
watch glass, with a drop or two of water added. Now, if a small crystal of 
the nitroprusside of sodium be placed in the mixture, if sulphur be present, 
the fluid will assume a splendid purple color, from formation of sulphide of 
sodium; this fluid passes from purple to a deep azure blue, and ultimately 
loses all its color. Dana. 

Sulphureted Hydrogen. Hydrosulphuric, or Sulphydric Acid. Hydrothion. 
This is a poisonous, colorless gas, having a fetid odor resembling that of 
rotten eggs; it is inflammable, burning with a blue flame and evolving a 
sulphurous odor. When present in laboratories, or other places, the inhala- 
tion of its vapor is deleterious, and this may be avoided by the diffusion of a 
little chlorine, or by spraying the atmosphere of the apartment with an 
aqueous solution of chlorine. Water dissolves about three times its volume 
of this gas ; solution of ammonia, or of potassa, dissolves it entirely. Sul- 
phureted hydrogen is sometimes evolved from the urine. Sulphureted hydro- 
gen is used, either in the form of gas, or solution, for the detection of lead in 
fluids, or for the separation of lead from liquids used in, or resulting from, 
chemical analyses. It forms a dark brown or blackish precipitate in liquids 
containing lead. It may be readily procured by gently heating sulphide of 
iron in dilute sulphuric acid; by the action of dilute sulphuric acid on sul- 
phide of potassium; or, by dissolving sulphide of lime half an ounce in 
distilled water a pint, and then adding dilute hydrochloric acid 2 fluidrachms. 
Liquid sulphureted hydrogen is made by passing the gas, as it is formed, into 
water to saturation. Another mode of preparing sulphureted hydrogen has 
been given : — introduce into a flask equal weights of granulated zinc and 
galena, in small fragments, and then pour upon them hydrochloric acid 



SUL 192 SUL 

diluted to the twentieth (1 of acid to 20 of water), so as to cover the mixture. 
Sulphureted hydrogen is soon disengaged regularly and in large quantity, 
mixed with a small proportion of hydrogen and hydrochloric acid ; this 
latter gas may be absorbed by means of a washing bottle. 

"In organic analyses, we have almost always to eliminate some principles 
with the acetate of lead. To separate the lead, authors say in a few words 
' to remove it by means of a current of sulphureted hydrogen.' This is easily 
said ; but the operator is to be pitied, for there are few manipulations more 
lengthy, more tiresome, and more uncertain in their progress and their results 
than this; and he is very fortunate if the flask or matrass does not break and 
throw the acid over his clothes, and perhaps upon his face. The current of 
gas diminishing, he stirs up the fire ; the contents of the matrass or retort 
swell up and pass over into the wash bottle. If the acid is in excess, there is 
a disengagement of hydrochloric acid gas not foreseen in the programme; if 
the sulphur is too dry, the apparatus breaks, etc. By the process hereafter 
given, these small dangers and inconveniences are avoided. This very simple 
method acts with the same efficacy in the preparation of chlorine by hydro- 
chloric acid and binoxide of manganese, and in that of oxygen by sulphuric 
acid and binoxide of manganese. — Mix with powdered sulphuret of antimony 
one-third its volume of siliceous sand, or powdered stone-ware; we may now 
throw upon it from the first a large quantity of hydrochloric acid and heat it 
actively without any uneasiness as to the results. The gas is regularly and 
abundantly evolved to the end. The mass becomes but slightly heated, and 
does not distil over into the wash bottle." Mehu, 

For urinary investigations the gas may be prepared as required, by means 
of a long bottle filled with dilute acid to one-third its capacity ; a copper rod 
is passed tightly through the cork, which has attached to its lower extremity 
a perforated leaden basin, in which the sulphuret is placed. When this basin 
is lowered into the dilute acid by means of the copper wire, the gas is 
evolved ; when enough has been procured, the basin can be drawn up out of 
the acid. A glass tube, also passed through the cork, allows the gas to escape 
into a washing tube, or as may be required. Babo's sulphureted hydrogen 
gas generator is a very cheap and safe apparatus for preparing and using this 
gas as required. 

SralpIiHret or Snlpliide of Ammonium. Ammonium Sulphide. Is some- 
times employed in analyses in the place of sulphureted hydrogen. It may be 
made as follows : — Pass sulphureted hydrogen gas through 3 parts of liquor 
ammonia until no further absorption takes place, then add 2 parts more of 
the solution of ammonia. Keep this in small, accurately well stoppered, 
green-glass bottles. At first this fluid is colorless, and deposits no sulphur on 
the addition of acids; ultimately, however, from atmospheric action, it 
acquires a yellow tint, and gradually deposits sulphur, until the fluid con- 
tains in solution nothing but ammonia. It is better to wash the gas before 
it is allowed to enter the ammonia, by having it pass through a small vial 
of distilled water. When properly prepared, a drop of it added to a little 



SUL 193 SUL 

saturated solution of sulphate of magnesia, gives no precipitate; if a precip- 
itate should occur, free ammonia is still present, and the fluid must be again 
subjected to the action of a stream of sulphureted hydrogen gas. 

Sulphuric Acid. Oil of Vitriol. Sulphuric acid is present in the urine 
in the form of sulphates of potassa, and soda, in the following proportions : 
3 grammes .50 in 1,000 grammes of sulphate of potassa, and 3 grammes in 
1,000 grammes of sulphate of soda. The average amount of this acid passed 
in 24 hours is 1.943 grammes (30 grains). Free sulphuric acid in presence of 
sulphates may be detected as follows, when this investigation is required: Mix 
the fluid under examination with a very little cane sugar, and evaporate the 
mixture at 212° F. to dryness over a water bath, in a small porcelain dish. 
If free sulphuric acid is present a black residue remains, or, if the acid 
exist in minute quantity, a blackish green. The other free acids in the urine 
do not give this reaction. 

Quantitative Analysis. 

In estimating the sulphuric acid by chloride of barium, we must be careful 
not to add any more of this latter solution after a barely perceptible cloudi- 
ness is obtained (in a clear portion of the fluid under examination) by the 
addition of another drop of the barium solution, as well as in another speci- 
men by a drop of solution of sulphate of potassa of strength exactly equiva- 
lent to that of the chloride of barium, about 1 part of pure sulphate of 
potassa to 12 parts of distilled water. Two or three specimens of the clear 
fluid under examination should be taken and tested. 

Place 100 c. c. of the urine under examination, in a beaker or Florence oil 
flask, and acidulate it with 20 or 30 drops of hydrochloric or nitric acid ; 
place on a sand or water bath and heat to boiling. Now let fall into the 
boiling urine from a graduated burette, 4 or 5 c. c. of the strong chloride of 
barium solution (see Barium), and allow the fluid to rest until the precipitate 
formed has all subsided to the bottom ; then add another c. c. of the chloride 
of barium solution, and again allow the fluid to rest before adding any more 
of this barium solution, and proceed in this manner, keeping the urine at the 
boiling point whenever this solution is added, and then removing it from the 
heat that the precipitate may subside. From time to time, by means of a 
pipette, 12 or 15 drops of the clear upper stratum of urine are heated and 
filtered through a small filter into a small test tube, and tested by the chlo- 
ride of barium solution, to ascertain whether a further precipitate occurs. If 
it does, return the few drops in the test tube to the beaker, and again add a 
little more of the test solution of barium. And so proceed until no further 
cloudiness appears on the addition of this test solution. 

In the trials with the 12 or 15 drops in the test tube, above referred to, 
Neubauer advises the dilute solution of chloride of barium to be used. If this 
gives a precipitate, pour the fluid in the test tube back again, and add more 
of the dilute solution, until a new trial with the test tube yields no further 
precipitate ; then 1 c. c. of this dilute solution corresponds with 1 milli- 
13 



SUL 194 SUL 

gramme of sulphuric acid. Add the quantities of the two test solutions 
together, putting the figures for the dilute solution one decimal further back, 
and then it may be taken into account as a strong solution. Let us suppose 
that we have used 11 c. c. altogether of the strong test solution, and 10 c. c. 
of the dilute, then 

11.0 c. c. of the strong solution, and 
1.0 c. c. of the mild solution, 



Make 12.0 c. c. of strong test solution used. 

The patient passes 800 c. c. of urine in 24 hours, how much sulphuric acid 

does it contain ? 12 c. c. of the strong test solution have been required to 

remove all the sulphuric acid from 100 c. c. of urine ; and as 1 c. c. of this 

solution corresponds to 10 milligrammes of sulphuric acid, — 12 c. c. are equal 

to 120 milligrammes. Multiply the quantity of urine passed in 24 hours, by 

the ascertained amount of sulphuric acid in 100 c. c. of this urine, and 

divide this by the amount of urine tested, 100 c. c; then 

800 X 120 QAA , . , . . . , _. , 
— = 960 grammes of acid m the urine of 24 hours. 

In the preceding process it should always be ascertained that no excess of the 
test solution of chloride of barium has been added to the urine under exam- 
ination ; this may be done by adding a drop of the clear fluid to the standard 
solution of sulphate of potassa (see Potassa), in a test tube; if no precipitate 
occurs, more of the barium test solution must be added ; if, however, merely 
a slight haziness or cloudiness takes place, the analysis is finished ; but, if too 
much precipitate is produced, there is an excess of the test solution of chloride 
of barium, and the analysis must be repeated upon a new specimen of the 
urine. 

An approximative estimation may be made by a process similar to that 
named under Phosphates in General, Estimation of Phosphates. If the chloride 
of barium solution at the y^th be used, y^th of a cubic centimetre of the pre- 
cipitate formed in the graduated tube, corresponds to grin .50 of sulphate 
of baryta. Multiply the ascertained weight of the sulphate of baryta by 
0.343, and we have the weight of the anhydrous sulphuric acid entering into 
its composition. 100 parts of sulphate of baryta correspond to 60.85 of 
anhydrous sulphate of soda, or to 74.76 of anhydrous sulphate of potassa. 
Mehu. 

Clinical Import. Albuminoid substances in becoming disintegrated, form 
at the same time, urea and alkaline sulphates ; the sulphates being the products 
of destruction of the tissues, and having no part in nutrition. The excretion 
of sulphuric acid (or sulphates) attajns its maximum shortly after a full 
meal, then diminishes up to the corresponding meal of the next day, when it 
again increases. As heretofore stated certain kinds of food augment its 
quantity as well as the ingestion of all bodies containing sulphur. Animal 
diet, physical or mental exercise, and sulphates that do not produce a purga- 
tive eflect, increase the amount of alkaline sulphates ; while vegetable diet 



SUL 195 TAR 

(with some exceptions), or fasting, diminishes it. The other causes that may 
modify the secretion of sulphuric acid are still imperfectly known. In disease, 
the variations have been but little, if at all, investigated. It is evident, how- 
ever, that in acute febrile affections, and whenever the patient takes little or 
no nourishment, an increase of sulphates in the urine will be the indication 
of an abnormal decomposition of the sulphureted elements of the body. 

Standard Solution of Sulphuric Acid. Analysis of Ammonia. Cautiously 
dilute 14 grammes of hydrated sulphuric acid with 200 grammes of distilled 
water ; and, when the mixture has cooled down to the ordinary atmospheric 
temperature, the amount of sulphuric acid contained in every 10 c. c. of it, 
is determined in two such parts of 10 c. c, through precipitation with chlo- 
ride of barium. When both experiments nearly agree, the average of them 
may be taken as correct. Thus, if we find that 10 c. c. of the diluted acid 
contain grm .505 of sulphuric acid, they will then be exactly neutralized 
by grm .2146 of ammonia. Consequently 1 c. c. of the dilute acid corre- 
sponds to grm .02146 of ammonia. 

Sulphurous Acid. If this acid be present in urine it may be detected 
by half filling a test tube with this fluid, and slightly acidulating it with 
hydrochloric acid ; if now a strip of starched paper, stained blue with a 
weak solution of iodine, be suspended in the tube just above the urine, the 
disengagement of the sulphurous acid gas will decolorize the paper. 

Sympexions. Sympexis. Nitrogenized concretions almost always observed 
in the fluid of the vesiculse seminales, have been termed sympexions by Ch. 
Robin, who has carefully studied them, but has not been able to ascertain 
their composition. They are in the form of small grains, very variable in 
size, of waxy consistence, forming a homogeneous mass, and break into frag- 
ments under pressure. Their chemical reactions prove that they are formed 
of nitrogeneous matter other than a simple concrete mucus, for acetic acid, 
instead of shrivelling and corrugating them, causes them to swell, become 
more transparent, and finally dissolves them. Not unfrequently they enclose 
spermzoons, blood globules, or debris of epithelium, etc. They hav,e also 
been found in the fluids of other parts of the body. 



T. 

Tannin. The effect of tannin upon the urinary constituents is not known, 
though, in some instances, it appears to increase the amount of urine. When 
administered internally, it passes off" in the urine as gallic and pyrogallic 
acid. A saccharine substance is also supposed to be present. Allantoin is 
found in the urine when considerable tannin has been taken. Schottin. — Solu- 
tion of Tannin. Take of pure tannin 1 part, distilled water 2 parts, by 
weight, and, to preserve the solution, add ether 1 part. Keep tightly corked, 
and in a cool, dark place. See Albumen. 

Tar. See Carbolic Acid. 



TAU 196 TES 

Taurin. A peculiar animal substance that may be extracted from bile; 
being present in cholinic acid, with cholalic (or clioloiclic) acid. It may be pre- 
pared from fresh ox-bile, which is to be boiled for some time with hydrochlo- 
ric acid. Filter, to remove the precipitate of dyslysine ; then evaporate the 
filtrate, and add alcohol. The taurin precipitates, while chloride of sodium 
and hydrochlorate of glycocoll remain in solution. Taurin forms tasteless, 
inodorous, colorless, transparent, regular hexagonal prisms, terminating in 4 
or 6 planes. It is a nitrogenous substance consisting of 25 per cent, of sul- 
phur, soluble in hot water, but not in alcohol or ether. Strecker produced it 
artificially. See Cholinic Acid. 

Tauroclsloric Acid. See Cholinic Acid. Bile Acids. 

Taurylic Acid. Hydraied Oxide of Tauryl. An acid found in small 
quantity in cow's urine, and, according to Staedeler, in very minute quantity 
in human. It resembles phenylic acid, but has a higher boiling point. Its 
presence in human urine has not been satisfactorily established. 

Tea. The effect of tea is but slight upon the urine; it diminishes to a 
very small extent the chlorine, uric acid, and sulphuric acid ; with an insuf- 
ficient diet, tea causes the body to lose its weight less rapidly than when it is 
not used. A large amount of infusion of tea, taken at a meal, increases the 
water of the urine, but does not sensibly affect the solids. 

Fragments of tea leaves are occasionally met with in urine. Under the 
microscope they present the cellular portion of the leaf, the cells being dark 
and of rather large size, with a light peripheral band between the dark part 
and the marginal outline, while minute spiral threads or vessels are projected 
from one or more parts of the margins of the cells. 

Test Fluid. In detection of Quinia in Urine. The formula for this prepara- 
tion having been overlooked in process No. 3, under Quinia, page 164, it is 
given at this place. It is as follows :— Take of pure acetic acid 30 minims, 
rectified alcohol 10 minims, dilute sulphuric acid 1 drop; mix. Process No. 
3 will detect the xo oW^h °^ a g ra i n of quinia in the urine. The process is 
that of Dr. Herapath. 

Test Papers. Test papers should be made of thick, substantial, pure, 
non-bibulous paper, and the color should be placed on it in a thin layer. 
Too much color destroys the sensitiveness for minute amounts of acid or 
alkali in solutions. For Acids. Exhaust litmus with strong alcohol ; then 
extract it with water, and brush strongly sized paper with it. Dry the paper, 
and then wash with distilled water to remove free alkali. When dry, cut 
into strips and keep in a dark, well closed bottle. Acids redden it; it is very 
sensitive. — For Alkalies. — 1. Dip blue litmus paper, prepared as just stated, 
in sulphuric acid diluted with just enough distilled water to redden the lit- 
mus. Dry, and then wash with distilled water to remove excess of acid. 
When dry, cut into strips, and keep in closed, darkened bottles. Alkalies 
restore the original blue color. N. B. — If strips of blue litmus paper are 
ruled with dilute sulphuric acid, so that each strip contains one red and one 
blue thick line, one immersion in a fluid will show at once whether an acid 



THI 197 TOR 

or an alkali be present. After penciling the paper with the acid, it should 
be dried and washed, as above. — 2. Turmeric Paper. Macerate turmeric roots 
in water until they are exhausted; dry them, bruise them finely, and ex- 
haust with alcohol. Apply on filtering paper, dry, and keep in corked bot- 
tles in the dark. This paper should have a fine yellow tint, which is changed 
to a brown by alkalies. Boracic acid changes it to a brown red. — 3. Make 
an acid infusion of the red petals of the rose, and apply to paper. This is a 
very delicate test. — Sulphureted Hydrogen. This substance in urine may be 
known by its rendering dark-brown or black, paper that has been dipped in 
solution of acetate of lead, and then dried. 

Other test papers are employed in chemical processes, but the above are 
sufficient in urinary investigations. 

Thionurate of Ammonia. To a cold, strong solution of alloxan add an 
aqueous solution of sulphurous acid, until, on agitation, there is no longer 
any sulphurous odor ; then add carbonate of ammonia to supersaturation, 
and keep boiling for half an hour. Abundant crystals form as the liquor 
cools, which are sparingly soluble in cold, but freely soluble in warm water. 

Tli ion uric Acid. Dissolve thionurate of ammonia in hot water, and add 
solution of acetate of lead as long as any precipitate occurs. Suspend the 
filtered precipitate in water, and add sulphureted hydrogen to effect decom- 
position. Separate the sulphuret by filtration, and, on evaporating the clear 
filtrate, crystals of thionuric acid form. These are permanent, freely soluble 
in water, though decomposed by boiling. 

Titrated. When a solution or chemical agent is quantitatively tested for 
the amount of such or such substance contained in it by the aid of standard 
or titrated solutions, it has been " titrated." — If an agent or liquid is directed 
to be titrated (tested or analyzed), it is to be quantitatively tested, as above 
observed. — A titrated or .standard solution, is one whose strength or chemical 
power has been accurately found by experiment. 

Tor ula Cerevisi». Torula Sacchari. Mycoderma Cerevisoz. ( Champignon du 
Ferment French.) Yeast or Sugar Fungus. (See Penicilmm Glaucum, and Micro- 
scopic Examination of Diabetic Urine, under Sugar.) This fungus, like the com- 
mon yeast plant,consists of numerous spores (minute oval cells) arranged in 
bead like rows, very much resembling the ordinary yeast fungus, though nearly 
one-third smaller in size. The size of the spores vary according to the age of the 
plant. The delicate, gelatinous cells found soon after the formation of the fun- 
gus just below the surface of the fluid, have a diameter of about mm .00362. 
At a later period when they have a fawn color, are heavy, and sink, their 
diameter varies from mm .02047 to mm .0425. See Fig. 31, page 178. 
This fungus is developed in urine upon standing for a certain time depending 
upon the character of this fluid ; in diabetic urine, it begins to form in a few 
hours, and is often developed within 20 to 36 hours after the urine has been 
voided, and this rapid appearance may lead to a suspicion of the presence of 
sugar. During the sporule and thallus stage of development, it is very diffi- 
cult to determine the torula from penicilium ; but the yeast fungus, in its 



TRA 198 TEI 

aerial fructification has a globular head, while the penicilium presents a tuft 
of branches. During the development of the torula, the urine ferments, any 
sugar in it is destroyed, carbonic acid is evolved, and several acids are pro- 
duced. It has been supposed that the torula was developed only in saccha- 
rine urine, but this is not the case, as it has been found in this fluid when 
no sugar could be detected. See Fungi. Saccharorayces Cerevisce. Vegetable 
Organisms. 

Transparency of Urine. Healthy urine is always transparent when 
voided, some time being required subsequently, before it becomes turbid, 
and which turbidity is due to a small, light, greyish white cloud, formed of 
the mucus and epithelia of the urinary passages, and which cloud gradually 
settles towards the bottom of the vessel. But, a transparent urine does not 
always indicate a normal condition of this fluid. — The transparency of the 
urine may be destroyed by several causes, as, an increased amount of mucus, 
the presence of urates, of earthy phosphates, of pus, of albumen, etc. — At times, 
the turbidity of the urine may exist at the time of its emission, but more 
frequently at some subsequent period, from formation and deposition of its 
salts, from the action of heat, or of chemical reagents. Occasionally, coloring 
matter may be present to a degree capable of interfering with the transpa- 
rency of the urine. When turbidity is present in this "fluid, we have to deter- 
mine its cause, by the use of processes and reagents, that have been named 
throughout this work. 

Trichomonas Vaginalis. An animalcule discovered in the muco-puru- 
lent discharge of leucorrhea by Dr. A. Donne. Its body is often round, though 
it assumes various forms, being more ordinarily elliptical, and having a 
diameter of from mm .008 to mm .02. It is provided with a flagellum and 
vibratile cilia, the former having a length of from mm .025 to mm .035, 
and of extreme tenuity. It moves in mucus with considerable activity, but 
much less so when water is added to it. Sometimes it is found alone, but 
more frequently united with others in groups of 2, 4, 6, and even more, their 
anterior extremities being free and moving their filiform appendages in every 
direction ; their posterior extremities being held together. When the mucus 
containing them becomes cool, these infusoria liquefy and disappear. They 
are sometimes observed in the urine of women having leucorrhea. It requires 
a magnifying power of 300 or 400 diameters, and a proper illumination to 
distinguish them from the inanimate spherical purulent globules in the midst 
of which they are moving. They can, by means of a viscid matter, fasten 
their posterior extremities upon the object glass, and then elongate their 
bodies. Donne's observations regarding this infusorium have been confirmed 
by Robin, Velpeau, Kolliker, Scanzoni, and others. 

Trimethylamin. An artificial or spontaneous volatile product of the 
decomposition of certain organic substances, characterized by its strong fishy 
odor. It has been found in herring pickle, in alcoholic preparations of 
animal tissues, and in putrid urine. It is a fluid, and is isomeric with 
propylamin. When a large quantity of ammoniacal urine is distilled, there 



TRO 199 TUR 

passes over carbonate of ammonia, trimethylamin, and other volatile bases 
in small quantities. This substance has been found useful in gout and 
rheumatism. 

Trommer's Test. For Sugar. To the suspected urine, in a test tube, add 
a drop or two of solution of sulphate of copper, and then liquor potassa in 
excess. Boil the mixture ; if sugar be present there will be a red precipitate of 
suboxide of copper. As this test has proven rather unsatisfactory in its opera- 
tion, the reduction tests of Pavy and Fehling are more generally preferred. 
Trommer's test (and similar tests) is frequently interfered with by certain 
organic elements of the urine; this fluid, upon being submitted to boiling 
after the addition of the reagents, presents a yellowish or yellow-brown 
color, but without any deposition of the red suboxide of copper ; to over- 
come this difficulty, the urine should be previously treated with an excess of 
animal charcoal, then filtered, and the filtered liquid may then be examined 
for sugar. — Dr. George Hay, of Alleghany City, has recently verified the 
truth of the above statement, and has remarked that Trommer's test as 
usually employed is fallacious and unreliable. From carefully conducted 
experiments he found that when the suboxide of copper is not precipitated 
from this test, as usually applied, it may be taken as a certain evidence that 
sugar is absent ; but the occurrence of such a precipitate in the urine is no 
positive indication of its presence. The method he advises, is to evaporate 
the urine over a water bath, then treat the dry residuum three or four times 
with boiling absolute alcohol, filter, and evaporate the filtrate to dryness, 
keeping it at the boiling point long enough to drive off all the alcohol. The 
remaining mass is dissolved in distilled water, then filtered, and the aqueous 
filtrate subjected to Trommer's test which now gives a positive result. Drug- 
gists' Circular, 1877, page 177. 

Tubal Nephritis. Bright's renal disease. Albumin aria. 

Tube Casts. See Renal Tube Casts. 

Tubercle Fragments in Urine. When tubercle is located in some 
part of the urinary passages, a deposit of small yellow, oval, cheese-like 
fragments may be found in the urine. These fragments, examined under the 
microscope, are seen to contain pus corpuscles, which do not present the 
usual nuclei under the action of acetic acid ; also disintegrated cells, consid- 
erable amorphous granular debris, disorganized connective tissue, cholesterin, 
minute oil globules, etc. They are about the -2oVo tn °f an i ncn m diameter,- 
and become transparent when acetic acid is added to them. Glycerin dimin- 
ishes their conspicuousness. 

Tubuli Bellini. Ducts of Bellini. The small non-tortuous uriniferous 
tubules which converge from the cortex of the kidney to the apices of the 
Malpighian pyramids. 

Turnip. This vegetable appears to give rise to an augmented quantity of 
oxalate of lime crystals; and, eaten in abundance, imparts a peculiar odor 
to the urine. 

Turpentine. This substance imparts the odor of violets to urine. In 



TYR 200 TYR 

some instances, it appears to increase the quantity of urine. In large doses, 
or taken for a long time continuously, it may occasion hematuria, and even 
albuminaria. 

Tyrosin. Tyrosin is of the same class of substances as leucin, which see. 
It is generally present with leucin, and is supposed to be produced in the 
liver, in which organ it has been detected by many investigators; it occurs 
in many of the animal tissues, is always present during the decomposition of 
albuminous substances, and has been found, by Liebig, as one of the products 
of decomposition of old cheese. Voit and Bauer think it very probable 
that leucin and tyrosin are among the first products of the decomposition of 
albumen. The mode of obtaining tyrosin from urine, when present in it, 
has already been stated under Leucin. In acute yellow atrophy of the liver, 
the urine, according to Neubauer, sometimes gives a spontaneous greenish- 
yellow crystalline sediment, composed of tyrosin and leucin, both of which 
will be present when the sediment is evaporated on an object glass ; the color 
is due to the presence of bile pigment. Beale has found tyrosin in urine 
containing much uric acid, which had been allowed to remain for many 
weeks in a warm place. 

Microscopical Characters. Unlike leucin, tyrosin. is crystallizable. Some- 
times it presents in globular masses, but more commonly in brush-like or 
sheaf-like clusters, constricted at their convergent points, and not unfre- 
quently crossing each other, forming a cross of four brush-like arms, and 
narrowed at their point of union at the center. These masses consist of 
numerous long, fine, white (or yellowish when colored by bile pigment), 
shining, silky, acicular prisms ; in the globular masses, which are readily 
broken down when compressed by the thin glass cover, these needles present 
a jagged appearance, in consequence of small spear-shaped crystals projecting 
from them. 

Chemical Characters. Tyrosin has neither taste nor odor, but, when burned, 
emits a disagreeable smell, resembling that of burnt horn ; it does not 
undergo sublimation. It is very soluble in boiling water, mineral acids, and 
alkalies ; difficultly so in cold water, and acetic acid ; and insoluble in alco- 
hol or ether. Dissolved in ammonia and then spontaneously evaporated, it 
remains unchanged, but yields larger crystals. Acids precipitate it from its 
alkaline solutions. — Perhaps the easiest chemical test for its detection is that 
of Scherer's, viz.: Place a few crystals, or some of the urinary deposit, upon a 
platinum spatula, moisten them with chemically pure nitric acid, and slowly 
evaporate to dryness ; a rich yellow substance is formed, together with oxalic 
acid. This yellow substance consists of the crystals of nitrate of nitro-tyrosin, 
C 18 H X1 N 3 8 , which are reddened by hydrochloric acid ; and when evap- 
orated, a deep, brownish-black residue is left. — Hoffman's test is said to be a 
very delicate one : Place some crystals of tyrosin in a test tube, add a little 
water and boil ; when the tyrosin is dissolved, add a few drops of solution of 
nitrate of protoxide of mercury to the hot liquid, which instantly assumes a 
rosy-red color, while a flocculent red precipitate forms after a short time. — 



URE 201 UKA 

Piria's test, although very sensitive, is not of such easy performance as that 
of Scherer's, besides being unreliable when leucin is present ; it is as follows: 
Place a small quantity of the crystals of tyrosin, or of the suspected urine 
from which any leucin present has been separated, in a watch glass, and add 
a drop or two of chemically pure sulphuric acid, which gives a red color. 
Cover the glass and allow it to stand for half an hour in a warm place ; then 
dilute with distilled water. Saturate the acid of the mixture with carbonate 
of baryta ; boil to decompose the bicarbonate of baryta ; filter, and to the fil- 
trate add a few drops of neutral dilute solution of perchloride of iron, when the 
presence of tyrosin, gives a beautiful violet color; the result of the action of 
the chloride of iron on the sulphate of tyrosin. — It is always proper, before 
investigating for tyrosin, to separate it from the leucin in the urine by the 
method described under this latter substance. 

Clinical Import. When leucin and tyrosin are present in urine there is 
almost always a diminution of urea. They are never found in urine during 
health, but only when certain maladies exist, as, typhus, variola, acute yellow 
atrophy of the liver, and probably in any hepatic disease in which the paren- 
chyma of the liver undergoes rapid disorganization. Tyrosin in the urine, is, 
according to Harley, "an almost certain sign of a rapidly approaching fatal 
termination." 



U. 

Ursemia. See Uremia. 

Uramile. Dialuramid. Murexan. Heat a cold saturated solution of 
thionurate of ammonia, to the boiling point, then add hydrochloric acid, 
and boil for a few minutes; on cooling, a crystalline precipitate of hard 
shining needles occurs. These are soluble in cold concentrated sulphuric 
acid, and in aqueous solutions of the fixed alkalies. The ammoniacal solu- 
tion, on exposure to the air, assumes a rose-red color, and if it be evaporated 
in the air, murexide is formed. Uramile is insoluble in water, alcohol, or 
ether, and in acetic, tartaric or citric acids. Boiling water, dilute phos- 
phoric, sulphuric, and hydrochloric acids, dissolve a minute portion of it. 

I'rana. A term applied to the ureter. 

Urane. A vessel for receiving the urine as it is voided. 

Uranium, Standard Solution of Acetate of. See Phosphoric Acid. 

Urapostema. A urinary abscess. 

Urates. Urates are met with in urinary deposits more frequently than 
any other substance, and are generally colored a delicate rose, brick -red, or 
brown red ; white urate sediments are rare. The more or less red, and occa- 
sionally white adhesive coating observed upon the sides or walls of urinals, 
consists of urates. Uric acid, being a bibasic acid, forms both acid and neu- 
tral salts, the latter, being much more soluble than the former which enter 
largely into the urate precipitate occurring in urine. Urate sediments are solu- 
ble by heating the urine, but fall again on cooling ; the addition of an alkaline 



UKA 



202 



UEA 



solution also dissolves them ; and, like uric acid, they give the murexide 
reaction. If, on heating in a test tube, a urine containing urates, they do not 
become thoroughly dissolved, it will be owing to the presence of insoluble 
salts mixed with them, as earthy phosphates, or of organized elements, pus, 
blood, etc. In this case the boiling urine should be filtered, and the filtrate, 
on cooling, will yield a deposit of urates free from foreign substances. There 
has been considerable difference of views among urologists concerning the 
composition of these amorphous deposits, some considering urate of ammonia, 
and others, urate of soda, as the principal salt in them ; analysis has proven 
the presence of soda and ammonia, and sometimes traces of lime and mag- 
nesia in them. And it is generally admitted at this day by the best investi- 
gators that the sodium urate exists in the largest quantity. The specific 
gravity of urine containing an excess of urates varies considerably ; thus a 
pah urine, becoming opaque on cooling, has sp. gr., at the time of its emission, 
of about 1.012; a pale amber-colored urine, giving a copious fawn-colored de- 
posit on cooling, has a sp. gr. of about 1.018 ; a high-colored urine, giving a 
reddish-brown, or brick-red sediment, has a sp. gr. of about 1.025. More gen- 



Fig. 33. 




a* 



Ordinary appearance of urate of ammonia. 

Urate of ammonia, less common than the preceding. 

Rare forms of urate of ammonia; the spicula being, 
probably, uric acid ; occasionally observed in albu- 
minous urine, and occurring in dropsy after scar- 
latina. 

Urate of soda, usual forms in urinary deposits. 

Urate of soda, rare forms ; differs from similar form 
of urate of ammonia, in the extremities of the 
needles of the latter being obtuse, while in the 
former they are acute. 



erally, however, the urine is 
high-colored, turbid, dense, 
and slightly acid ; some- 
times it may be neutral, or 
alkaline. If hydrochloric 
or acetic acid be added to 
urine containing urates, the 
uric acid is separated in 
crystalline forms. See Figs. 
35, 36. 

Under the miwoscope, if the 
sediment be recently depos- 
ited, the urates are presented 
in the form of small, irregu- 
lar, amorphous, granules, 
often clustered in patches, 
or in ramified rows like 
sprigs of moss. If the sedi- 
ment is old, other forms 
will be observed, either 
brown or yellow globules 
with dark outlines, isolated 
or grouped, or stellated 
masses, or spherules fur- 
nished with bristly points 
like chestnut burr. See 
Fig. 33. 



URA 203 URA 

The following are the urates met with in the urine : — 

1. Urate of Ammonia, Acid. Acid Amnionic, or Ammonium Urate. This 
is more especially met with in alkaline urine, mixed with earthy phosphates. 
Under the microscope, it appears in opaque globular masses, which are beset 
with fine points similar to the spines of a hedgehog; sometimes in roundish 
or dumbbell-like masses, which polarize light; but more generally in a 
dark, granular, perfectly amorphous sediment, varying in color, according to 
the quantity of urohematin present, from a white to a pink, brick red, pur- 
ple, or brownish red. See Fig. 33. This urate is dissolved when the urine 
is heated, reprecipitating as the fluid cools ; it is soluble in liquor ammo- 
nia, and in liquor potassa, evolving ammonia when treated with the latter 
liquor, and from which solution uric acid is precipitated on the addition of 
acetic acid. Hydrochloric, or, acetic acid, added to urine containing urate 
of ammonia, occasions the gradual formation of uric acid, while the ammonia 
forms a soluble salt with the acid. Place any of the different forms of urate 
of ammonia in a watch glass, and add some liquor potassa ; the urate will 
become decomposed, evolving ammonia which will restore the blue color to 
dampened and reddened litmus paper. If urate of ammonia be heated in a 
platinum capsule, it will be wholly dissipated. If a drop of acetic acid be 
added to a little of the deposit, plates of uric acid will gradually form. With 
nitric acid and ammonia, the deposit will give the murexide reaction. Urate of 
ammonia is less soluble in water than urate of soda, requiring a temperature 
of about 200° F., for its solution. 

2. Urate of Lime, Acid. Acid Calcic or Calcium Urate. This salt exists 
in very small quantity in the urine, and is rarely met with. It forms a white 
amorphous powder, which, when exposed to a red heat, leaves carbonate of 
lime. It is sparingly soluble in water, though the presence of chloride of 
potassium increases its solubility ; it parts with uric acid when treated with 
acetic acid. It has been found in calculi, and in gouty swellings around the 
joints. — If some amorphous, or, crystalline, urate of lime be placed upon a 
platinum spatula and calcined, a white gritty powder, carbonate of lime, will 
be left, which is soluble in hydrochloric acid with disengagement of carbonic 
acid gas. Acetic acid added to urate of lime decomposes it, and uric acid 
crystals are formed, which may be verified by the murexide test. See Benzoate 
of IAthia. 

3. Urate of Magnesia, Acid. Acid Magnetic, or Magnesian Urate. This 
salt is very common in urinary calculi, though it has not been detected in 
human urine ; it is probable, however, that a little of it is present, perhaps, 
occasionally. It crystallizes in small rectangular plates, of various lengths, 
and sometimes so delicate as to represent needles. In crystalline deposits, 
the elongated, ribbon-like plates are more abundant. The plates and needles 
are colorless, transparent, and usually grouped together parallelly, or in fan 
form ; sometimes they form very minute stelliform masses, and again, spher- 
ical groups with a dark center. The crystals polarize light. According to 
Bensch, they are more soluble in cold than in boiling water. The dried 



UKA 204 UKA 

crystals are very efflorescent. — To analyze these crystals, calcine some of them 
on a platinum spatula, when a white residue of carbonate of magnesia will 
be left. Place some of this residue on a glass slide, and dissolve it by adding 
a small drop of hydrochloric acid; to this solution add a drop of solution of 
phosphate of soda, and then a drop of ammonia; the arborescent crystals of 
ammonio-magnesian phosphate will appear under the microscope. The 
presence of uric acid may be verified by subjecting the urate of magnesia to 
the murexide test. 

Bigelow describes a Biurate Hydrate of Magnesia, which forms in large, quad- 
rilateral crystals, having regular angles, transparent, of straw color, insoluble 
in water, and not decomposed by acetic, or ordinary hydrochloric acid, agents 
which promptly decompose the preceding form of urate of magnesia. Pure 
concentrated hydrochloric acid gradually decomposes them with formation 
of uric acid. Exposed to the air these crystals become opaque and silvery 
white ; when heated, they break with a noise, violently scattering the frag- 
ments around ; hence, in calcining them, the heat should be low at first to 
drive off their water of crystallization. 

4. Urate of Potassa, Acid. Acid Potassic, or Potassium Urate. This salt 
has been found in urinary sediments, and in urinary calculi, in very minute 
quantity. It has been found in almost pure uric acid calculi. The remarks 
on urate of soda, as to its amorphous and crystalline forms, and its general 
constituent formation, will likewise apply to the urate of potassa. "When 
treated with bichloride of platinum, similar to the method named under 
urate of soda, its behavior will be very different, regular octohedral prisms 
are formed, which are only slightly soluble in water, and do not polarize 
light. 

5. Urate ©f Soda, Acid. Acid Sodic, or Sodium Urate. Biurate of Soda. 
This salt generally appears in the form of very small, irregular, amorphous 
granules. It may be prepared artificially by dissolving uric acid in a warm 
solution of ordinary phosphate of soda; it then appears in microscopic, 
hexagonal, prismatic crystals, usually united in stellar groups. Similar 
forms are met with in urine undergoing the process of alkaline fermentation. 
Microscopic examination sometimes detects very complicated forms in this 
transition period of the fermentation ; the uric acid crystals, separated dur- 
ing the acid fermentation, have commenced re-solution in greater or lesser 
quantity, and become studded with elegant groups of prismatic crystals of 
urate of soda; at the same time, concentrically striated spherules, consisting, 
probably, of urate of ammonia, may be seen placed alongside of the pris- 
matic crystals. Litmus is still feebly reddened by this urine. As the fer- 
mentation progresses, and when the urine has acquired a neutral reaction, 
prismatic groups of acid urate of soda may sometimes be seen, being now 
accompanied with fine large crystals of ammonio-magnesian phosphates. 
Solution of urate of soda allowed to evaporate spontaneously, gives a deposit 
of this urate in simple spherical masses and granules. 

Urate of soda is soluble in water of about 100° F., and forms a less floccu- 



URA 205 URA 

lent precipitate than that of urate of ammonia. It presents three forms 
under the microscope, viz., a colorless amorphous powder; regular globules 
with yellow center (neutral), and semi-transparent prismatic crystals that 
faintly polarize light. These crystals, whether met with in calculi or in sedi- 
ment, may be determined by placing some of them on a platinum capsule, 
and calcining. A white residue, carbonate of soda remains; this fuses at an 
elevated heat ; is dissolved in a few drops of water ; and restores the blue 
color to reddened litmus paper. If a drop of this aqueous solution be placed 
on a glass slide, and a drop of solution of bichloride of platinum be added 
to it, there will form, when observed under the microscope, large, indefinitely 
long, transparent prisms, possessing, in a high degree, the power of polarizing 
light ; these prisms are very soluble in water. — Urine containing urate of 
soda, becomes clear, from solution of the urate under heat ; or, on the addi- 
tion of a little liquor potassa; if to the urine, rendered alkaline by the 
potassa, an excess of acetic acid be added, crystals of uric acid will be depos- 
ited in from 6 to 12 hours. 

6. Urate of Soda, Xentral. Neutral Sodw, or Sodium Urate. This is a 
pulverulent deposit, more commonly met with in the urine of persons labor- 
ing under severe fevers, and is generally associated with a little urate of lime, 
and traces of urate of ammonia. Having once appeared in the urine of 
men, or of carnivora, it is very apt to remain throughout the remaining part 
of the individual's life. When pure, it crystallizes in isolated mammilla;, or 
in mammiilated groups. The granules of this urate in the urine are ovoid 
or spheroidal, sometimes one extremity more enlarged than the other; their 
periphery is distinctly marked, black or brownish, and their center is yellow- 
ish-brown, or, a more or less intense reddish color. When urine contains 
neutral urate of soda in solution, and an acid be added to it, the urine will 
become more or less opaque from formation of acid urate of soda, which will 
ultimately be deposited in fine granules. This may sometimes mislead the 
practitioner, who, having a urine of this character to examine, and observing 
an opacity produced in it by the addition of nitric acid, may mistake it for 
albumen ; but, on the application of heat, the deposit will be redissolved and 
thus correct his error. 

When these urates occur singly they present but little difficulty in analysis, 
but when they are mixed, or are united with uric acid, the analysis becomes 
more complicated. In such cases, which occur frequently, the practitioner 
will have to pursue the several processes heretofore named, on different por- 
tions of the sediment or urine, in order to detect the various bases, as, soda, 
ammonia, lime, etc., always observing the general aspect of the precipitate, 
and the characters of the crystals. 

t Mierochemical Diagnosis and Separation of Urates. — 1. Place a drop of the 
deposit upon a glass slide ; add a drop of dilute nitric acid to it ; apply heat; 
as soon as the fluid evaporates, a reddish circle will appear. When the slide 
becomes cold add a drop of ammonia to the circle on the slide, if it be a 
urate or uric acid, the circle will change from a reddish to a purplish-red or 



UKA 206 UEA 

violet color (murexide reaction). — 2. Place a drop of the deposit on a glass 
slide, and add a drop of acetic or hydrochloric acid ; cover with thin glass, 
and examine under the microscope, crystals of uric acid will appear. See 
Figs. 35 and 36. 

Treat a drop of urate deposit, freed from any foreign elements it may 
contain, with a drop of hydrochloric acid, and allow it to spontaneously 
evaporate on the glass slide under a bell glass. When the evaporation has 
terminated, upon examining the residue under the microscope, the following 
crystals will be found to have formed : — a. Cubes or octohedra of common 
salt, and of chloride of potassium, if the sediment contained urates of soda 
and of potassa. See Figs. 13 and 34. — b. If the sediment contained urate of 
ammonia, elegant arborizations of hydrochlorate of ammonia will be seen. 
These arborizations may be thoroughly observed on allowing a drop of limpid 
saliva to spontaneously evaporate on a glass slide. — c. Crystals of uric acid 
may be seen. See Figs. 35 and 36. The two preceding named salts are solu- 
ble in a drop or two of water added to the preparation ; the uric acid crystals 
will remain intact. (For the separation of urates and other sediments, see 
Microchemical Diagnosis of Earthy Phosphates, etc., under Phosphates.) 

Clinical Import. The sediments of urates appear under various influences. 
When the urine is concentrated or deficient in its fluid element, as, from ex- 
cessive perspiration, watery evacuations at stool, abstaining from aqueous 
draughts, or from other causes, urates will be deposited as the urine cools. 
An excess of water in the urinary secretion, will hold the urates in solution 
for some time after cooling ; the lower the temperature, the more quickly 
are they deposited. A slight departure in diet, an abnormal fatigue, any 
nervous shock, will suffice to determine a deposit of this kind. But in these 
cases there is no indication of disease, as the deposits are temporary. A 
deposit in urine is always an indication of some abnormal condition, more 
especially when it persistently remains for days and weeks, and should never 
be disregarded. The appearance of urates in the urine may be an indication 
of commencing gravel or calculus, especially when it persists, and no febrile 
or inflammatory symptoms are present; in most cases of this kind, disease of 
one or more of the abdominal organs is apt to exist. Urates may be present 
in phthisis, fever, acute inflammation, acute rheumatism, and in all cases 
where the tissues are destroyed more rapidly than their supply by the nitro- 
genized elements. The sudden appearance of urates in pneumonia and 
pleurisy when resolution and absorption commence, in gout and rheumatism, 
and in active inflammatory or febrile conditions, indicates a change, more 
generally, of a favorable character. An excessive use of animal food, 
or where the ordinary amount of nutrition continues the same but without 
much physical exercise, will occasion the appearance of urates in the urine 
there being, in such cases, a greater provision of nitrogen than is required 
for the reparation and replacement of the tissues. Again, the nitrogenous 
elements may not be in excess, but can not be assimilated by the digestive 
apparatus, as, in dyspepsia. When not due to any of the preceding condi- 



URE 207 URE 

tions, nor to diminution of temperature, the presence of urates may indicate 
some derangement of the cutaneous functions, in which the kidneys are called 
upon to compensate for the defect in these functions. Blows over the region 
of the kidneys, fatigue of these organs, or congestion of them due to local 
causes, are very apt to be attended with deposits of urates ; and when these 
are in such excess as to be deposited while the urine is in the bladder, the 
case assumes a serious aspect. The excess of urates in the urine of gouty 
persons, explains their presence in crystalline form in the articular surfaces. 
According to Charcot and Cornil, they may even be the cause of the albu- 
minous nephritis so often supervening in these cases, as their presence in the 
kidneys would seem to demonstrate. SeeUric Acid. 

Urea. Urea (Ur) is the most abundant and the most important principle 
of urine ; it is found in the urine of birds, serpents, and animals, but is more 
abundant in that of the mammalia. It is a normal organic constituent of 
urine, a great excess or deficiency of which, in this fluid, indicates some patho- 
logical condition. It is the chief final product of the metamorphosis of the 
albuminous or nitrogenized tissues of the organism which are eliminated in 
order to give place to a new substance the materials of which are furnished 
by the food. Urea represents five-sixths of the nitrogen absorbed with the 
food; it appears to be formed in or taken up by the blood, and is eliminated 
through the kidneys. Claude Bernard states that when the renal organs are 
removed, the urea is excreted by the gastro-intestinal mucous membrane, in 
the state of carbonate of ammonia. Urea has been found in the saliva, tears, 
milk, bile, liquor amnii, fluids of the eye, perspiration, etc., in small quan- 
tity. From 25 to 40 grammes of urea are passed daily, on an average; but 
this amount is subject to great variations, determined by the weight, age, sex, 
occupation, and diet of the person. When urea is present in excess, the urine 
is apt to have a high sp. gr. 1.020 to 1.030 or more, is usually clear, and 
free from sediments; when it is deficient, the sp. gr. may be reduced to 1.001 
to 1.008, with an increase in the quantity of urine. When free from coloring 
matter and pure, urea is a white, semi-transparent, crystalline body, the 
crystals being four-sided or acicular, and having a bitter, saltpetre-like taste, 
and no odor. It is soluble in water and alcohol, hardly soluble in ether, 
insoluble in oil of turpentine. It is readily decomposed by heat, hydrated 
alkalies, strong mineral acids, putrescent organic matter, mucus, pus, and 
yeast. At 248° F., it fuses. Its presence in the urine causes chloride of 
sodium which usually crystallizes in cubes, to form octohedral crystals, 
crosslets, and daggers, see Fig. 13 ; while, should chloride of ammonium, 
which crystallizes in octohedra, be present in the urine, urea causes it to 
crystallize in cubes. Urea is prepared artificially, by various methods which 
it is not in the province of this work to explain. 

According to M. Grimaux (Chimie Organique Elementaire. Paris, 1872), 
urea may be considered an amide, that is, an ammoniacal salt minus water: 
now, urea corresponds to neutral carbonate of ammonia minus two atoms of 
water ; it is then the amide of carbonic acid, or carbamide. We know that 



UKE 



208 



UEE 



urea was obtained, complete in all its parts, by Wiehler, in 1829 ; since 
which, this synthesis has been reproduced by various processes. It should 
likewise be understood that the absorption of water by urea converts this 
into carbonate of ammonia; this is precisely what occurs in the fermentation 
of urine, and hence its peculiar ammoniacal odor. — It is difficult for the 
medical practitioner to study the variations of urea in human urine and draw 
satisfactory practical indications from them. There does not yet exist any 
simple and sufficiently exact process of examination. The volumetric 
methods, which are considered the only ones, and of which most physicians 
can avail themselves, are very complicated and inexact. 

Qualitative Analysis. 

Urea is too soluble in water to form a spontaneous deposit in the urine. 
When it exists in excess, or in normal urine artificially concentrated, its 
presence may be readily demonstrated by combining it with nitric or oxalic 
acid. If albumen be present in the urine, it must be removed, by the process 
hereafter stated. — 1 1. Place a small quantity of the (non-albuminous) urine, 
to be examined, in a watch glass, or on a glass slide, and evaporate it to the 
consistence of syrup ; to this, when cold, having previously filtered it, while 
hot, to remove any urates or phosphates that may be deposited, add about 
one-third its volume of pure nitric acid. Immediately (or after a short 
time, depending upon the amount of urea present), a yellowish crystalline 
mass (yellowish from the coloring matter of the urine) of agglomerated 
pearly glistening scales or plates will be formed, which are crystals of nitrate 

of urea : should the crvstal- 



Fig. 34. 




• JkJ W*r NWS 





A. Evaporated residue of healthy urine. 

B. Oxalate of urea. 

C. Nitrate of urea. 



lization occur slowly, fine 
rhombic prisms will be 
formed. (See Fig. 34). To 
study this salt under the 
microscope, a drop of the 
concentrated urine may be 
planed on a glass slide, in 
which we immerse a strand 
of cotton thread, and then 
cover with a thin glass, 
allowing about one-half of 
the thread to pass beyond 
the glass cover. Now, upon 
the protruding extremity 
of the thread place a drop 
of nitric acid ; this reagent, 
by capillarity, penetrates 
the thread under the glass 
cover and acts upon the 
urea in the drop of urine ; 



URE 209 URE 

after a variable time, crystals of nitrate of urea will appear in the fluid 
around the thread. 

Pure nitrate of urea {urea or ureal nitrate), is soluble in water and alcohol, 
not very soluble in nitric acid, is not acted upon by atmospheric influence, 
explodes when quickly heated on platinum foil to a high temperature, but, 
at 'JS4° F., it is decomposed into urea, suboxide of nitrogen, nitrate of ammo- 
nia, and carbonic acid.— "When the crystals form rapidly in urine, the quantity 
and sp. gr. of the whole urine passed in 24 hours must be ascertained, because 
a single specimen of urine may appear richer in urea, from a diminished 
amount of water. 

2. t As nitric acid vapors injure the metallic parts of the microscope, a 
concentrated solution of oxalic acid may be added to the non-albuminous 
urine, and which will give crystals of oxalate of urea. Oxalate of urea (urea 
oxalate), crystallizes in long, thin, hexagonal plates or prisms, of rhomboidal 
form, the angles being less acute than those of the nitrate; sometimes these 
crystals are separate, at others adhering in groups. They are occasionally, 
but very rarely, observed in concentrated human urine. This salt is soluble 
in 23 parts of cold water, but freely soluble in boiling water. See Fig. 34. 

3. Mix 20 c. c. of urine with 10 c c. of baryta solution, and remove the 

precipitated sulphates and phosphates by filtration ; neutralize the filtrate 

with nitric acid and evaporate to dryness over a water bath. Extract the 

residue with alcohol ; evaporate ; again exhaust the residuum with absolute 

alcohol, which will yield on spontaneous evaporation, very pure, colorless 

needles of urea. By filtration, drying the crystals and weighing them, we 

can form a pretty accurate estimation of the amount of urea passed at each 

urination. Thus, if, in the above process, we find that 1.5 grammes of urea 

are present, and the amount of the urine passed at the time was 240 c. c, we 

240 
calculate — —- = 12 X 1-5 = 18 grammes of urea. By examining the 

urine of each urination in this manner, the amount of urea passed in 24 
hours may be determined sufficiently correct for practical purposes. Liebig. 
— 4. Evaporate 15 c. c. of non-albuminous urine to one-fourth its volume, 
and treat it with one volume of nitric acid ; white nitrate of urea is precip- 
itated. Treat this precipitate with solution of carbonate of baryta, carbonic 
acid is produced, with nitrate of baryta and urea. Separate the urea from 
the insoluble nitrate of baryta by alcohol; filter, and evaporate the filtrate 
to obtain the urea. — 5. Take urine in the state of full alkaline fermentation, 
pour it upon filtering paper in a filter; after a time the filtration slackens, 
owing to the pores of the paper becoming filled with globules of a certain 
ferment. Now wash the paper with distilled water until the washings no 
longer give an alkaline reaction, and carefully dry the paper at 95° to 104° 
F. (This paper will convert even a very dilute solution of urea into car- 
bonate of ammonia.) After it is dried, color it yellow with turmeric, dry it, 
cut it into strips, and preserve in dark, well closed bottles. Any solution, 
containing urea even to the yoTffo tn P art > Wl ^ cause this paper, when soaked 
14 



URE 210 UEE 

in it, to become covered with brown spots. The liquid to be tested must, in 
all cases, be neutralized to decompose alkaline carbonates and bicarbonatea 
which interfere with the action of the test; neutral alkaline salts do not. 
Musculus. — See Specific Ch'avity. 

N. B. As albumen interferes with the determination of urea in the urine 
by any of the qualitative or quantitative processes, it must first be removed. 
For this purpose, after having removed the sulphates and phosphates by 
baryta solution, as named above (No. 3), add, to the filtrate, absolute alcohol, 
which having a stronger affinity for urea than the albumen has, takes up the 
urea and renders the albumen insoluble. Filter to remove the albumen, and 
evaporate the filtrate to the bulk of urine employed, and proceed according 
to the process employed for the determination of urea. Thudicum. — If urine 
containing albumen be passed through a filter filled with crystals of sulphate 
of soda, these crystals will arrest the albumen and prevent it from entering 
into the filtrate. — De Luca removes albumen from the urine by ammoniated 
cupric nitrate, filtering and using the filtrate for the analysis of urea. — 
Mucus, pus, or any other deposit in the urine, must be removed by filtration 
or decantation before commencing an analysis. — The coloring matter of bile 
may be precipitated from urine by adding solution of acetate of lead to it. — 
Any nitrogenized matters in the urine may be precipitated by the addition of 
a sufficient quantity of solution of acetate of lead, acidulated with a few drops 
of acetic acid ; then filter, remove excess of lead by a current of sulphureted 
hydrogen. ; again filter, and use the urine for detection of urea. 

The following method has been recommended as sufficiently accurate for 
practical purposes in determining the (physiological or pathological) amount 
of urea present in a given specimen of urine : — 

t Upon a glass slide or platinum foil, at 60° or 65° F., place a drop or two of 
the urine, and add to it an equal quantity of concentrated nitric acid, if crys- 
tals of nitrate of urea form at once, or within five minutes, there is an excess 
of urea, the proportion of which will depend upon the rapidity and extensive- 
ness of the process. If the crystallization occurs within from 5 to 10 minutes, 
— or, if the urine be slowly evaporated to one-half its bulk, and then an 
equal quantity of the acid be added, followed by immediate crystallization, — 
the urine contains a normal or average per cent, of urea. If crystallization does 
not occur within 10 minutes, — or immediately, with the evaporated urine, — 
then there is a deficiency of urea, to a greater or lesser extent. 

Quantitative Analysis. 

Several methods have been made known for the quantitative determination 
of urea in the urine, as, Liebig's, Bunsen's, Davy's, Leconte's, Ragsky's, 
Knopp's, Huffner's, Yvon's, etc. Of these the following only will be given : 
1. Liebig's. Into a beaker glass place 20 c. c. of the non-albuminous urine to 
be examined, and add to it 20 c. c. of the solution of baryta (for analysis of 
urea); this will precipitate all the sulphates, carbonates, and phosphates. 
Agitate the mixture thoroughly with a glass rod, and allow it to rest. Pass 



URE 211 URE 

the mixture through a filter, previously moistened with distilled water, and 
refilter if the liquid is not clear. Of this nitrate, take 20 c. c., equal to 10 
c. c. of the urine, and add to it a few drops of solution of nitrate of silver, in 
order to precipitate all the soluble chloride present, which interferes with the 
test, preventing the urea from being precipitated by the solution of protonitrate 
of mercury. Make sure that the liquid is alkaline, adding a drop or two of 
solution of carbonate of soda to make it so, if necessary. Now, having 
placed the standard solution of protonitrate of mercury into a burette or 
graduated pipette ; filling it up to the level of the first graduation (zero), 
gradually allow this solution to drop into the above prepared urine, until 
there is added a slight excess of the standard solution, which may be known 
by a drop of the mixture producing a yellow stain when placed on prepared 
soda paper.'* This color produced, the analysis is finished. Read oft' the 
amount of standard mercuric solution, on the graduated burette, required to 
produce this yellow stain, which will show the amount of urea in 10 c. c. of 
urine. Suppose 50 c. c. of this standard solution were required in the 
preceding process, then, as 1 c. c. of it corresponds to 0.01 gramme of urea, 
50 c. c. will correspond to 0.5 gramme of urea. The patient having passed 
800 c. c. of urine in the 24 hours, we multiply the 800 by the 0.5 gramme of 
urea found in 10 c. c. of the urine, and divide the result bv the amount of 
urine tested, 10 c. c. Thus, 

800 X 0-5 An 

— = 40 grammes. 

The above process of Liebig's, although giving very accurate results, re- 
quires considerable time and patience in its performance, and is better adapted 
for the chemist, than for the practitioner, who, after having once experimented 
with either of the following three processes referred to under section 2, will 
be enabled to readily and satisfactorily employ it in any case in which the 
quantitative estimation of urea is desired. Besides, there are certain modifi- 
cations and corrections to be made in Liebig's method, not required in the 
others; thus, if the urine contains more than 2 per cent, of urea, it would 
require to be diluted to a certain extent; if more than 1 per cent, of chloride 
of sodium be present, we must either remove the chlorine by a graduated 
solution of nitrate of silver before undertaking the operation, or, subtract 
2 c. c. from the total c. c. of mercurial solution used to determine the number 
of milligrammes of urea contained in 10 c. c. of the urine. If the urea sink 
to 1 per cent, or less, we must for every 5 c. c. of mercurial solution used less 
than 30 c. o, subtract 0.1 c. c. from the sum of c. c. actually used. Other 
modifications are also required for the presence of ammonia, albumen, etc., 
which it is unnecessary to name here, as but few physicians would ever under- 
take the process, as exact as it may be, when others, nearly as exact and 
of more ready performance, can be resorted to. 

* The prepared soda paper is made by soaking a sheet of white filtering paper 
in a saturated solution of pure carbonate of soda. When dry it may be cut 



UKE 212 UKE 

into strips, and be kept in a well -closed wide-mouthed bottle. The above is 
Harley's modification of Liebig's process, and will be found useful. 

t 2. — Yvon's Process. This is a modification of Knopp's and Huffner's, and, 
with the necessary articles on hand, the analysis can be made in 5 or 6 min- 
utes at the bedside of the patient. The instruments consist of a long, wide 
bell-mouthed beaker or mercury jar, and a glass tube, ureometer, 40 centi- 
metres long, with a calibre of 1 centimetre in diameter. This tube is divided 
into two compartments by a glass stop-cock placed towards its upper quarter, 
which allows a communication between the two compartments to be estab- 
lished or suppressed at will. Commencing at this stop-cock, the tube is 
graduated, above and below it, into cubic centimetres and tenths of the same. 
The lower part of the tube is the longest, from its extremity to the stop- 
cock, and is designed to be placed into a mercury jar, as hereafter described. 
— The standard solution employed consists of solution of caustic soda, 36°, 
30 grammes, dissolved in distilled water 125 grammes, to which add, when 
cold, bromine 5 grammes, and agitate strongly. Allow it to rest for some 
time, and, after decantation, a fine yellow, clear, transparent fluid remains, 
which has to be frequently renewed, as it loses considerable of its strength in 
a very short time. By keeping the solution of caustic soda, separately, this 
preparation may be made in small quantity, whenever required, by adding to 
any given amount of it the proper proportion of bromine. As a test liquor of 
this standard solution, 1 gramme of pulverized urea, well dried by a pro- 
longed sojourn under a bell glass with sulphuric acid, is dissolved in distilled 
water so as to have 5 c. c. of the solution equal to 1 centigramme of urea. 
After the action of the standard solution of hypobromite of soda, upon this 
solution of urea, 37 divisions of the tube, or f £ths of c. c. of gas, will corre- 
spond to 1 centigramme of urea. 

Ten cubic centimetres of the non-albuminous urine are diluted with dis- 
tilled water to make a volume of 50 c. c, and of this diluted urine from 1 to 
5 c. c. are operated upon, according to its richness in urea. Polyuric urine 
requires no dilution. We must always endeavor to have no more than 40 
divisions of gas, in order not to too greatly increase the volume of the stand- 
ard solution to be employed, and the dimensions of the column of liquid. 
The method of proceeding is as follows: — Open the stop-cock and plunge the 
inferior extremity into the jar filled with pure mercury, until this has arisen 
to a level with the lower part of the superior compartment ; then close the 
stop-cock, raise the tube (but not entirely out of the mercury), the inferior 
compartment of which is filled with the mercury, and maintain it in this 
position by means of a strap or collar, which forms part of the complete 
apparatus. Into the upper apartment place from 1 to 5 c. c. of the diluted 
urine, open the stop-cock, and carefully make the fluid flow into the inferior 
compartment, closing the stop-cock before any air can pass along with it. 
Wash the receptacle at the superior part of the tube with several drops of 
distilled water, and carefully pass this into the lower apartment, by means 
of the stop-cock, as in the previous instance. This done, place into the 



URE 213 URE 

upper receptacle 5 or 6 c. c. of the standard solution, and, as in the first in- 
stance, make it pass into the lower apartment, raising the tube a little should 
this be necessary. Agitate by an up and down motion, but without removing 
the tube entirely out of the mercury, having the stop-cock closed, of course. 
Decomposition occurs immediately, the urea is separated into water, nitro- 
gen, and carbonic acid gas; the last being absorbed by the excess of alkali, 
nitrogen alone remains in the tube. To render the mixture more exact, raise 
the tube, close the lower orifice, while this is under the mercury, with a fin- 
ger, and shake it ; then carefully replace it in the mercury. The liquid soon 
becomes limpid when all the gas has collected together, and the amount of 
gas may be read off on the graduated divisions at the level of the fluid 
remaining in the lower compartment. The measure of the gas is made in a 
beaker filled with water, being careful to properly place the surface of the 
liquid in the tube on a level with that of the fluid in the beaker. 

For instance, 5 c. c. of the diluted urine have been operated upon, and 
we find 22 divisions of gas produced, and as 5 c. c. of the standard solution 
represents 1 centigramme of urea, we have f-f of a centigramme of urea. But 
the urine has been diluted to 5 times its volume with water, from which we 
can readily conclude that 1 c. c. of the original undiluted urine contains ff 
of a centigramme of urea. If 800 c. c. of the urine are passed in 24 hours 
we have 800 X 22 -j- 37 = 4 grms .754 of urea in 800 c. c. of urine ; or, 5 
grms .945 of urea in 1,000 c. c of urine. — Uric acid, creatine, creatinine, and 
the greater part of the nitrogenous mattei-s of the urine are decomposed by 
the standard bromated solution. M. Leconte advises to deduct 4.5 parts for 
1,000 of the nitrogen found. But. in pathological cases, can this rule be 
considered as exact? Should the urine be partly putrescent, or a part of the 
urea be converted into carbonate of ammonia, M. Yvon's process gives 
equally a good result. (The complete apparatus, with special instructions, is 
sold by M. Alvergniat, passage Sorbonne, Paris,). 

More recently several similar processes have been presented to the pro- 
fession, by various parties; it is unnecessary to name them all. Messrs. 
Russell & Watson, of England, have adopted one. Their proportions 
slightly differ from the preceding, thus : 20 grammes of caustic soda are 
dissolved in 50 c. c. of water, to which solution is added 5 c. c. of bromine. 
Their instrument costs 8s. 6d. sterling, and is manufactured by Messrs. Cetti, 
Brook street, Holborn, — full directions accompanying. — R. Apjohn has 
likewise devised a simple and readily worked apparatus, being in principle 
somewhat similar to the preceding. Chemical News, 1875, page 36. See 
Esbach's Method. — 3. Dr. Geo. B. Fowler, of New York, has advised a new 
and simple method for the quantitative estimation of urea, somewhat similar 
to that of Dr. Roberts' for determining the amount of sugar. Into a glass 
cylindrical jar, about 7 inches in depth and 1 inch in diameter, pour some of 
the urine to be examined and take its sp. gr. Pour out this urine into some 
convenient vessel, and carefully cleanse the jar. Now pour into it a portion 
of Squibb's hypochlorite of sodium and take its sp. gr. These two sp. gr. 



UEE 214 UEE 

are to be added together and their sum divided by 8, which will give the sp. 
gr. of the following mixture previous to decomposition : — Into another glass 
vessel, about 9 inches in depth and 1| inches in diameter, pour 15 c. c. of the 
urine that was contained in the smaller jar previous to cleansing it, and add 
to it seven times its quantity of the hypochlorite (105 c. c). Active effer- 
vescence at once commences, and when it has ceased, agitate the mixture 
from time to time until the urea is effectively decomposed. Then, take the 
sp. gr. of the remaining fluid, and deduct this from the sp. gr. previous to 
decomposition. Every degree of. sp. gr. lost will indicate 7.791 milligrammes 
of urea in every c. c. of the urine. Neither albumen nor sugar exert an 
injurious influence upon the exactness of this process. For more minute 
particulars see New York Medical Journal, June, 1877. 

Clinical Import. Urea is derived from disintegration of the nitrogenous 
tissues of the body, and from decomposition of nitrogenized food. Its secre- 
tion is greater during the waking hours than during sleep, and its presence 
in urine is augmented by active physical or mental exercise, by animal diet, 
and by drinking excessively of water ; a purely animal diet increases the 
proportion of urea in the urine nearly one-third, while vegetable diet only 
will diminish it in about the same proportion ; a diet consisting of non-ni- 
trogenous articles will lessen its amount one-half or more. The weight, 
occupation, and food of the person appear to regulate the quantity of urea; 
the better the diet, and the more active the occupation, the greater the phys- 
iological amount of urea. (See Agents.) Its presence indicates, to a certain 
extent, the wear and tear of the system during health, Avhen the various 
factors above named are taken into consideration, at the same time. The 
average amount of urea in the urine has already been stated ; when it greatly 
exceeds, or falls below, this average, persistently remaining so for some time, 
it indicates a pathological condition. As heretofore observed, when a urine, 
not concentrated, to which an equal volume of nitric acid is added, promptly 
yields a number of nitrate of urea crystals, urea is said to be " in excess." 
When, even after concentration, but few crystals present, or form slowly, 
there may then be a " deficiency of urea." 

k persistent excess of urea (sp. gr. 1.030 or more), and especially when at 
the same time a diminished amount of nitrogenized food is taken, indicates 
a diseased condition in which there is an excessive disintegration of the tis- 
sues. This appears to be the case in the early periods of acute diseases, as, 
fevers (excepting yellow fever), pneumonia, meningitis, exanthemata, etc. 
This excess may likewise be present in certain deranged conditions of the 
digestive, and the cutaneous, functions, diabetes insipidus, during an attack 
of epilepsy, as well as in many other affections. As the acute malady reaches 
its height, the abnormal increase of tissue-metamorphosis diminishes to an 
extent that occasions a diminution of urea below the normal amount, and 
when convalescence is about to occur, the quantity of urea gradually rises to 
its normal figure. 

Diminished or deficient urea in the urine (sp. gr. 1.001 to 1.008, with pro- 



URE 215 URE 

fuse urination), may be due to decrease in tissue metamorphosis, the result of 
a want of nutrition, or of a deficiency of oxygen ; it may also be due to renal 
disease, in which, though urea be formed in normal quantity, it is not ex- 
creted by the kidneys. Deficiency of urea, when owing to the latter cause, 
is always of a serious nature, because the retained urea, acting as a poison, 
occasions uremia and death. (Ammonemia is entirely different in its symp- 
toms from uremia, and is more frequently amenable to treatment. It is the 
result of reabsorption of the ammonia of the urine in the bladder, which 
may occur from a retention of urine, and especially when the urine becomes 
ammoniacal from decomposition of its urea.) Deficient urea indicates a 
serious disease of the cortical portion of the kidneys; this deficiency is met 
with in Bright's disease, and in any malady in which the kidneys fail to 
properly eliminate. It is also met with in minimum amount in dropsy, par- 
alysis, anemia, yellow fever, acute yellow atrophy of the liver, cirrhosis, 
certain affections of the respiratory organs, and in many chronic affections. 

In acute or inflammatory conditions, when the excess of urea continues, 
and even augments after the acme has passed, the prognosis is unfavorable. 
In albuminaria the prognosis is much more favorable when the urea remains 
normal, than where it is deficient. And in all conditions of the system, 
where deficient urea is gradually or rapidly followed by an increase in its 
quantity, with corresponding improvement in the patient's general condition, 
we may augur favorably. 

In determining the excess or diminution of urea in the urine, the practi- 
tioner must not allow himself to be misled by judging of it from its propor- 
tion to a certain amount of fluid, because, during the febrile condition, when 
the urine is scant and high colored, or concentrated, it will then present an 
apparent increase or excess, and during convalescence, when this fluid is 
passed in large amount or profusely, the same proportion of urea in it would 
show an apparent great diminution or deficiency. The determination should 
be made upon the whole amount of the urea passed in 24 hours; by this 
method the decrease of this substance in acute diseases will be found much 
less than is generally supposed ; indeed, it will frequently be reduced. to a 
very minimum amount. 

According to M. P. Brouardel there is a direct relation existing between 
the functional activity of the liver and the excretion of urea, so that, in all 
probability, a great part of the urea encountered in the urine is formed in 
the liver, this formation being in direct proportion to the size of the liver. 
From his investigations, he infers that the quantity of urea depends upon 
the integrity of the hepatic cells, and the greater or lesser activity of the 
hepatic circulation. 

Ureal. Of or belonging to urea. 

Urecchysis. Infiltration of urine into the cellular membrane. 

Urema. See Urine. 

Uremia. A generally fatal malady, due to the poisoning of the blood by 



UKE 216 UKI 

urea, which has not been eliminated from this fluid by the kidneys. See 
Urea (Clinical Import). 

Ureoritrine. See Uroerythrin. 

Ureorrbea. A flow of urine, as diabetes. 

"Uresis. The voiding of urine. 

Ureter. The long membranous tube connecting the urinary bladder with 
the kidney, and through which the urine passes to be emptied into the 
bladder. There is one for each kidney. 

Urethra. The canal through which urine is discharged from the bladder. 
In women it is an inch or an inch and a half long ; in man, its length varies 
from 7 to 11 inches, and is divided into the prostatic portion, quite wide and 
dilatable, and about 16 lines in length; the membranous portion, the narrowest 
portion of the canal (excepting the meatus), about 6 lines in length inferiorly, 
and 9 lines superiorly, concave on its upper surface and convex on its lower ; 
the spongy portion, about 6 to 8 inches long; and the meatus urinarius, or ex- 
ternal orifice, the most contracted part of the canal. 

Urettirorrliagia. Bleeding from the walls of the urethra. 

Uretlsrorrliea. A continuous flow of any fluid from the urethral wall. 

Urethroscope. An optical instrument designed for visual examination 
of the urethral walls, and so arranged as to permit the use of certain instru- 
ments during the inspection. The instrument consists of a tube to pass into 
the urethra, and a concave mirror to throw light through the tube into this 
canal, somewhat like that employed for ophthalmoscopic, or laryngoscopic 
examinations. 

Uric Acid. Lithic Acid. Urylic Acid. Bezoardic Acid. Uric acid is 
found in the urine of omnivorous and carnivorous animals, but not in that 
of the herbivorous ; it is likewise present in the urine of birds, serpents, and 
insects. In human urine it is in combination with some base, as, soda, am- 
monia, lime, potassa, from which it may be separated in crystalline form by 
the addition of acetic, hydrochloric, or nitric acid. When met with, in urine 
just voided, in the free state, but which is rarely if ever the case, its presence 
is due to accidental or pathological causes; although it is frequently observed in 
gravel and calculi, sometimes forming the principal substance of a calculus. 
When urine drawn off from the bladder by a catheter, presents a deposit of 
more or less uric acid crystals, there will be great reason for fearing the for- 
mation of uric acid calculi. The amount of uric acid in health passed with 
the urine daily varies according to the character of the sex, the diet, climate, 
and exercise, from grm .340 to 1 grm .478. When this acid is in excess, 
the urine will have a sp. gr. of 1.020 to 1.025, or more. — Uric acid is the pro- 
duct of the disintegration of the nitrogenized tissues or of the albuminous food, 
the metamorphosis being of a lower grade than that which eliminates urea, 
and which is due to less perfect oxidation. A more perfect oxidation con- 
verts uric acid into urea. 

Pure uric acid is a white, light, crystalline powder, inodorous, tasteless, 
and feebly acid; it is insoluble in alcohol, ether, and acetic acid; nearly 



UKI 



217 



UEI 



insoluble in nitric and hydrochloric acids ; soluble in 11,000 parts of cold 
water, and in 2,000 parts of boiling; readily soluble in liquor potassa, and in 
concentrated sulphuric acid from which water precipitates it; and sparingly 
soluble in dilute solution of carbonate of potassa. Insolubility in am- 
monia, will distinguish it from cystine which is soluble in this alkaline 
fluid. Exposed to a red heat, uric acid is decomposed without being fused; 
by dry distillation, a sublimate of ring-form is obtained, consisting of urea 
and cyanuric acid; hydrocyanic acid and carbonate of ammonia likewise 
escape, and a porous coal containing nitrogen remains behind. One part of 
uric acid gradually added to four parts of concentrated nitric acid dissolves 
with effervescence, and is converted into a crystalline pulp containing alloxan. 
The uric acid is decomposed into alloxan and urea, and the nitric acid into 
nitrous, which immediately decomposes the urea into carbonic acid and nitro- 
gen. It must not be forgotten, however, that urates and carbonates, as well 
as calcined ammonio-magnesian phosphate, equally dissolve with efferves- 
cence in nitric acid. Uric acid may also be determined by the murexide test 
(see Purpurate of Ammonia), and by Schiff 's test (see Carbonate of Silver). 

XIII. Table of 



i. Calcination f 
at a red heat. \ 



2. Solubili- 



3. Action of 
alkalies. 



4 Action of 
concentrated 
nitric acid. 



5. Action of 
dilute nitric 
acid. Murex- 
ide. 



6. Action of 
potassa. 

7. Reaction 
of nitrate of 
silver. 



Chemical Characters of Uric Acid. 

No residue. 

A light black residue (a porous coal containing nitrogen. Neubauer.) 

a. Insoluble in cold water ; slightly soluble in boiling. 

6. Insoluble in dilute hydrochloric acid. 

c. Soluble in potassa from which, if a slight excess of acid be added, crys- 
tals are precipitated. 

d. Soluble in alkalies. 

Triturated with caustic alkalies, unctuous compounds are formed, and am- 
monia is not set free. 
Dissolves with effervescence and forms a crystalline pulp. 

/-Alloxan, which forms the crystalline 
Explanation of /-Uric acid is de-J mass, 
the reaction. J composed into |tt •> 

(.Nitric acid, do Nitrous acid} which 

J (^JNitrogen. 

Causes of er- f Urates. ( Dissolve equally with effervescence, as 

"■< ■< well as calcined ammonio-magnesian 

{Carbonates. (_ phosphates. Beale. 

Upon heating and slowly evaporating to dryness, a red residue remains, 
which, treated by a few drops of ammonia, becomes purple or violet-red 
{murexide, purpurate of ammonia). If testing is for the detection of traces 
of uric acid, an excess of ammonia must be avoided ; moisten a glass 
rod with this alkali, and blow the vapors from it upon the residue, the 
rod being held close to it without contact. — Caffein gives the same reac- 
tion. 

The red residue, referred to above, when treated by potassa, gives a violet 
color, which disappears under heat. 

Dissolve traces of uric acid in carbonate of soda. With this solution touch, 
lightly, a paper upon which a drop of solution of nitrate of silver has 
been allowed to spread. A dark spot is produced (reduction of the nitrate 
of silver.) Will detect 1-1,000 to 1-500,000 of uric acid. 



{Carbonic 
acid. 
Ni 



Reaction of the Murexide. — According to Hardy's recent investigations, the 
characteristic color of uric acid is principally due to its modified anhydrous 
alloxan, then after the addition of ammonia to the isolloxalate of ammoni- 
nm. Chimie Biologique, p. 455. 



UEI 218 UKI 

+ Qualitative Analysis. 

Add to the urine a little acetic, nitric, or hydrochloric acid, after a longer 
or shorter time, depending upon the amount of uric acid present, and the 
degree of concentration of the urine, crystals of this acid will be precipitated, 
which can be examined under the microscope. Or, under the microscope, a 
drop of a sediment of urates may be treated with a drop of acetic acid when 
the peculiar crystals will appear. The uric acid is displaced from its com- 
bination with the alkaline bases, and presents itself in more or less volumin- 
ous broAvn or yellow crystals. If these crystals be separated from the urine 
by a pipette, and placed in a test tube, the addition of liquor potassa will 
dissolve them ; upon adding acetic or nitric acid to this solution, the crystals 
will reappear, of different forms, and nearly colorless. Should any doubt 
exist as to their being uric acid, some of the preceding named chemical tests 
may be used. 

Quantitative Analysis. 

To 100 c. c. of urine add 10 c. c. of chemically pure nitric acid ; agitate the 
mixture, and then set it aside for 24 hours in some cool place. Collect the 
uric acid crystals, that have been precipitated, upon a weighed filter, and 
wash thoroughly with distilled water until the addition of a solution of nitrate 
of silver to a little of the washings, no longer gives a precipitate. Dry the 
filter and crystals at a temperature of 212° F., and, then weigh; the weight 
of the two, minus the weight of the filter, will give the amount of uric acid 
contained in 100 c. c. of urine. Now, if 1,000 c. c. of urine be passed in 24 
hours (or whatever may be the amount), and 5 grammes of uric acid be found 
in 100 c. c. of the urine, we calculate the amount of uric acid passed in 24 

hours, thus: = 50 grammes of uric acid in the 24 hours urine. — 

According to Neubauer, any error in this process, relative to the solubility 
of the uric acid, may be corrected by adding 0.0045 grm. to the amount of 
uric acid found in each and every 100 c. c. of the urine and the water used 
in the washing. Should the urine be considerably diluted, as in polyuria, it 
should be evaporated to Ath its volume before adding the nitric acid. If 
albumen be present, it should be removed by acetic acid or heat, and filtration. 
2. To 100 c. c. of the urine add enough sodium carbonate to render it strongly 
alkaline ; filter to remove the earthy phosphates, and to the filtered fluid, 
add 100 c. c. of saturated solution of chloride of ammonium, and allow the 
mixture to rest for several hours without agitation. The urate of ammonium 
which is deposited upon the sides and bottom of the containing vessel is 
collected upon a weighed filter ; the beak of the funnel is then corked, and 
hydrochloric acid at the 10th added, for the purpose of converting the urate 
into uric acid, which is washed, allowed to dry, and then weighed with the 
filter holding it. To correct for uric acid lost add 14 milligrammes for each 
100 c. c. of urine. This process is based upon the slight solubility of the acid 



URI 



219 



URI 



Fig. 35. 



urate of ammonium, which require? 1.600 parts of cold water to dissolve ; 
though not exempt from errors, it gives tolerably accurate results. Fokker. 
t Microscopic Examination. Pure uric acid is generally in oblong, smooth, 
square plates; but in the 
urine, many different forms 
are met with, being deri- 
vation- of quadrangular 
rhombic tablets, or of hex- 
angular plates, the angles 
of which are usually more 
or less obtuse. See Figs. 
35, 36. Sometimes they 
are spindle-shaped, at oth- 
ers, short cylinders, cask- 
shaped ; again, they may 
be in long needles variously 
grouped, in plates, or in 
prisms. Not' unfrequently 
they are in fan-shape, in 
coarse or fine rosettes, in 
comb-shape, dentated like 
a saw, in dumb-bell form, 
etc. With some very rare 
exceptions they are always 
colored yellow, red, or 
brown, and, sometimes, in 
abnormal urine blue, black, 
or yellow ; the paler the 
urine, the less color they 
present, and vice versa. 
The colorless crystals are 
deposited from their solu- 
tion in liquor potassa. 
' These crystals are sometimes so large as to be recognized by the naked eye; 
those in plates or tablets present, under the microscope, granulations and 
lines, as if small fissures or cracked places abounded in them. The more 
transparent plates exhibit most splendid colors under polarized light. The 
various crystalline forms of uric acid are not always met with in any single 
specimen of urine ; they may all be referred to some modification of the 
rhombus, square, or rectangle. They are very recognizable by their color, 
and soon undergo a change by uniting with the ammonia liberated by decom- 
position, and have a tendency to become amorphous. As the rule, though not 
invariably, a spontaneous crystallization of uric acid, within 24 hours or so 
after the emission of the urine, indicates an excess of this acid ; it may also be 




D. 



Crystals of uric acid with serrated edges, deposited 
from very acid urine. 

Crystals do., rhomboid form, generally flat. 

Crystals do., squares or cubes, in long continued de- 
posits, — in calculous disease. 

Crystals do., rare forms, accidental varieties of B 
and C. 

Crystals do., often found mixed with urate of ammo- 
nia, or oxalate of lime. N. B. — All the crystalline 
forms of uric acid appear to be modifications of the 
rhombic prism ; they vary in color from the palest 
fawn, to the deepest amber, or orange red, 



UKI 



220 



UEI 




Varieties of Uric Acid Crystals. 



Fi9- 36. deposited when there is a 

diminution in the propor- 
tion of alkaline base. Any 
doubts concerning the crys- 
tals present in urine, may 
be removed, by the solubil- 
ity of uric acid in liquor 
potassa, and their subse- 
quent reappearance on the 
addition of acetic or nitric 
acid. Urates an.d phos- 
phates disappear when ace- 
tic or hydrochloric acid is 
added to them ; uric acid 
remains undissolved. 

Clinical Import. The pres- 
ence of uric acid in the urine 
appears to be due to imper- 
fect oxygenization of the 
blood, which augments the 
quantity of this acid and lessens that of urea. Thus, it is found in excess in 
febrile, inflammatory, and exanthematous diseases, in affections of the respira- 
tory organs, the heart, spleen, and liver, in leucocythemia, derangement of 
the cutaneous functions, in certain cutaneous diseases, etc. It is common 
among intemperate persons, and in all those conditions of the system which 
interfere with perfect oxidation of the nitrogenized ddbris of the tissues. In 
cancer of the liver it is said to exist in great excess, being spontaneously 
deposited in the urine ; this spontaneous deposition has also been observed in 
other diseases of this organ, as well as in dyspepsia, splenic, and cardiac affec- 
tions. Uric acid may be precipitated from the urine, in the urinary passages, 
from an increased amount of the acid phosphate of soda, in this fluid, or, 
perhaps, from acid fermentation ; hence, uric acid gravel in the kidneys or 
ureters, so frequently observed among certain patients. See Urea and Urates 
{Clinical Import.) Solvents to hold uric acid in solution in the urine are, 
phosphate of soda, phosphate of ammonia, benzoic acid, benzoate of lithia, 
and alkaline tartrates, citrates or carbonates. — Uric acid is stated to be 
lessened in quantity in the urine, in yellow and remittent fevers, in diabetes, 
in cholera, albuminuria, anemia, chlorosis, hysteria, and in certain stages of 
gout and rheumatism. Dr. Garrod has described a method for ascertaining 
the presence of uric acid in the blood of gouty persons; the "thread process." 
Place from 4 to 6 grammes of the serum of blood in a large watch glass, or 
flattened glass capsule, and add from .369 to .554 millilitres (6 to 9 minims) 
of acetic acid of ordinary strength, which addition is generally accompanied 
with the escape of a little gas in bubbles. Mix the fluids thoroughly, and 
immerse into the mixture two or three strands or fibres of thread drawn from 



URI 221 URI 

a piece of muslin or linen. Allow the whole to rest in a dry, moderately 
warm place for 36 or 48 hours, when upon removing the threads and exam- 
ining them under the microscope, crystals of uric acid will be seen deposited 
on them. This process will detect the 65 % ft0 th of uric acid in the blood. If 
the blood is not at the examiner's disposal he may substitute the serum from 
a blister, provided this be not applied over a point attacked by the gouty 
inflammation, because this inflammatory action causes the uric acid to dis- 
appear from points where it previously existed. Fresh fluid should always 
be used for these testings. — the presence of uric acid in the blood is an excel- 
lent means of diagnosis, as this acid is not found in acute articular rheu- 
matism, nor in chronic rheumatism. But it may be found in other diseases 
than gout, as lead colic, Bright's disease, etc. 

Uric Oxide. See Xanthine. 

Uricemia. An excess of uric acid in the blood. 

Urinal. A vessel for receiving the urine as it is voided. There are sev- 
eral kinds of these vessels, for males as well as females, adapted to the 
peculiar occasions for which they are required. A urinal in which urine is 
passed for examination, should hold at least 2,000 c. c, and be provided with 
a tight fitting cover to keep out foreign substances ; if it be graduated, the 
amount of urine passed per 24 hours can be read ofl' very quickly and with- 
out the extra trouble of measuring in a separate vessel. 

Urinary. Of, or pertaining to the urine. 

Urinary Casts. See Renal Tube Casts. 

Urinary Sediments. The terms urinary sediment, urinary deposit, are given 
to the various substances precipitated from urine in which they are held in 
solution or suspension, when this fluid is at rest for a longer or shorter time. 
The terms nebula, enozoi'ema (cloudiness or turbidity) are applied to a light- 
greyish flocculent cloud, formed by the urinary mucus holding various 
corpuscles in suspension, and appearing upon the cooling of the urine, the 
transparency of which it diminishes. See Epithelium, Mucus. — Sedimentary 
urine may be turbid at the very moment of its emission (organized sediments, 
pus, blood, and phosphatic deposits), or, it may issue perfectly clear and become 
turbid shortly afterwards (urates). In either instance, the urine should be 
passed into a conical graduated vessel, if this can be had ; but any other ves- 
sel will answer provided it be clean and not too large. Indeed, if the vessel 
has not been carefully cleansed, the various foreign bodies it may contain 
will mingle with the urinary deposit and be so many causes of error. As 
stated heretofore, it is always advisable to accustom one's self, by previous 
examinations, to recognize under the microscope various kinds of dust, ani- 
mal hairs, the textile fibres of our clothing and linen, grains of sand, oil 
globules, etc. In hospitals, grains of starch are very often found mingled with 
the sediments, and not unfrequently in large amount ; they are apt to pro- 
ceed from the starch powder so frequently employed as a topical application. 
We must expect to find them in the urine of women. They can be determined 



UEI 222 UEI 

with certainty by means of iodine water which colors them blue or deep violet. 
See Iodine; also see Preliminary Remarks at the opening pages of the work. 

It is an absolute illusion to attempt to class urinary sediments according 
to their color, their solubility by heat or in certain reagents, or, to the acid 
or alkaline reaction of the urine, and from these different characters to draw 
means of distinguishing between them. To determine the composition of a 
sediment from its color, would be to expose one's self to daily errors. This 
is why (whatever may be the authority and the competency of certain 
authors) we do not consider as practically useful tables given for the diagnosis 
of sediments, which suppose that we have under examination a type-sediment 
of urates, phosphates, or oxalates, etc. — In the usual conditions of practice, 
the practitioner by means of a small pipette takes up some of the urinary 
sediment, then allows a drop of it to fall upon the center of a glass slide, 
which he covers with thin glass, and, thus prepared, examines it under a 
microscope ; that which he may see is given below in the table, under General 
Microchemical Analysis of a Sediment, in which are indicated the elementary 
physical and chemical characters that may enable him to form a provisional 
diagnosis concerning the elements under observation. This diagnosis he can 
subsequently confirm by referring to the detailed characters of each body, 
separately explained throughout the various pages of this work. 

But this is not all. For instance, a drop of acetic acid is added to the 
object to ascertain the solubility of ammonio-magnesian phosphatic crystals. 
If these crystals only exist in the deposit, the reaction is very distinct ; they 
all disappear. But matters do not usually occur in this manner. These 
crystals are mixed with other crystalline, amorphous, or organic elements, 
which the acetic acid dissolves, modifies, or respects. Then the reaction, in- 
stead of enlightening us, increases our uncertainty ; and if the action, which 
this reagent exerts upon all bodies that may be met with in a sediment, is 
not perfectly present to the mind, we will be obliged to undertake long, 
wearisome, and frequently fruitless testings, upon the chemical properties of 
each body taken by itself. To obviate this difficulty, the reality of which 
we have too often recognized, we have summed up, in the form of a table, 
easy to consult, the action of the ordinary reagents upon the elements of 
which the sediments are usually composed. And that this table may preserve 
its practical character, those substances only accidentally met with in depos- 
its, as well as rare bodies, are excluded. 

Previous to this table, however, it is deemed best to give, for the informa- 
tion of the reader, the composition of the sediments after the reaction of 
urine, and the more simple chemical characters of several of them. 

Probable Composition of a Sediment after the Reaction of the Urine. 

Acid Urine, pediments generally colored more or less deep red. — Urates; uric 
acid, always in small quantity; oxalate of lime, ditto; phosphate of lime, 
ditto (often crystalline or in small dark spherules, grouped or isolated) ; 



URI 223 URI 

hippuric acid, very rare; cystin, ditto; tyrosin, ditto (in urine containing 
biliary pigments). — Various organized bodies. 

Alkaline Urine. Sediments generally colored more or less dirty white. — Ammonio- 
magnesian phosphate; phosphate of lime; oxalate of lime, in small amount; 
urate of soda, and of ammonia, in dark globules bristling with sharp spikes. — 
Mucus; pus; various organized bodies. 

The deposits of urates and of uric acid are the only ones soluble by heat, or 
by the addition of an alkaline solution, soda or potassa. — The deposits of 
phospates and of carbonates are the only ones soluble in acetic acid, and 
insoluble by heat, or by the addition of an alkaline solution. The carbonates 
dissolve with effervescence. Observe that this effervescence may be due to the 
carbonate of ammonia of alkaline urine, which is more commonly the case; 
if it be due to carbonate of lime, by repeating the reaction under the micro- 
scope, bubbles of gas will be seen oozing from the surface of the small 
blackish bodies. 

Complete Chemical Analysis of a Sediment. Place the deposit in a test tube 
with foot, and wash it with a small quantity of cold distilled water, and 
repeat it several times until the decanted supernatant liquid is colorless. 
Then treat the deposit the same as if it were a pulverized calculus. See 
Calculi (Table of Qualitative Analysis.) 

i General Microchemical Analysis of a Sediment. 

With a pipette, take up some of the sediment which it is desired to exam- 
ine, and place a drop of it on a glass slide ; it is always advantageous to 
dilute it with a little distilled water or some of the clear urine, so as to 
render the preparation more transparent; gently mix the additional fluid 
with the drop of the deposit, by means of a needle point, or a small point of 
wood, and then place a thin glass cover upon it. (This cover will not be 
necessary if the operator uses a chemical microscope.) The drop of fluid 
should not spread beyond the margins of the thin glass cover, an accident 
which will certainly happen with beginners who, in microscopic examinations, 
have a marked inclination to place an excess of the substance to be investi- 
gated upon the glass slide. In such a case, quickly dry the slide, and place 
another, but smaller, drop of the sediment upon it. Bear in mind, that the 
smaller the amount dropped upon the slide, the better it is for the examina- 
tion ; and by sufficiently diluting the small drop, the different bodies become 
separated, and the examination becomes much more easy and distinct. — In 
the investigation, a magnifying power of 300 diameters is at first employed, 
and then, to better observe certain minute elements, one of 500 diameters ; 
in the table below, the magnifying power to use, in certain particular cases, 
has been indicated. 

In applying reagents, two processes may be employed ; the pointed extremity 
of some blotting or filtering paper may be insinuated between the slide and 
thin glass cover (or it may be closely applied against the latter) while a drop 



UEI 



224 



URI 



of the reagent is placed upon the other extremity of the paper, at a short 
distance from the thin cover. The paper, absorbing the fluid by capillarity, 
establishes a current passing from the point upon which the reagent was 
deposited, through the paper, to the thin glass. What occurs may then be 
observed, and the chemical reaction which ensues be investigated. This is a 
delicate process, and requires considerable experience in order to properly 
execute it ; but, in certain doubtful cases, it is truly valuable. It has the 
inconvenience of displacing the various elements composing the preparation, 
but we may follow them by gradually moving the slide. 

Another much more expeditious process consists in treating a small drop 
of the sediment upon a glass slide, by an excess of the reagent, then cover 
the whole with the thin glass, and examine the result under the microscope. 
When, by a preliminary observation of the original drop of the sediment, 
its contents have been well noted so that their forms, etc., can be correctly 
remembered, it can be seen whether, under the influence of the reagent, they 
disappear, or become changed. — Nitric acid should never be employed under 
the microscope, only exceptionally, and hydrochloric acid as seldom as pos- 
sible ; the vapors from these acids rapidly deteriorate the metallic mounting 
of the objective. When they are employed, the objective should be promptly 
and carefully wiped with a piece of fine old linen, or, a soft piece of glove 
leather. — When coloring reagents are used, a few seconds should be allowed 
that the various elements may be impregnated with them. 



XIV. Table. 
Non-organized Bodies. 



Distinctly 
crystalline - 
bodies. 



r Very voluminous crys- 
tals, generally isolated, 
transparent, with sharp 
edges. Typical form a 
coffin-lid. 

Large crystals, but f 
generally grouped, al- 
ways colored in yellow 
or brown ; surface often 
fissured ; outlines very 
dark. 

Very small crystals, 
much smaller than a 
leucocyte, isolated, very 
transparent and very 
refractive, with sharp \ 
edges, octohedral form, 
sometimes letter envel- 
ope. Requiring 400 di- 
ameters. 



Soluble in acetic 
acid. 



Insoluble in acetic 
acid. 



Insoluble in acetic 
acid. 



Ammonio- 
magnesian 
Phosphates 
See. 



Uric Acid. 

See. 



Oxalate of 

Lime. See. 



UKI 



225 



URI 



Amorphous 
bodies. 



f Granules roundish or 
oval, with dark blackish 
outlines, isolated, or 3 
or 4 united in a star-like 
form, in beads, etc. 

Granules very pale, 
much smaller, very 
transparent, and diffi- 
cult to perceive; always 
united by irregular 
punctated patches (the 
most common aspect.) 

Grains roundish, iso- 
lated, with concentric 
or radiating strise (some- 
times both together), 
more or less opaque, and 
blackish. 

Granules small, yel- 
lowish, of variable size, 
sometimes very small 
and disposed in branch- 
ing series, like twigs of 
moss (recent sediments); 
sometimes larger, in the 
form of globules, with 
dark outlines and yel- 
low center, united in a 
mass like frog's eggs, or 
else isolated and brist- 
ling with points (old 
sediments). 

Granulations very 
fine, isolated, agitated 
with a dancing, revolv- 
ing movement (Bruno- 
nian movement). 



Soluble in acetic 
acid. 



Soluble in acetic acid 
but with disengage- 
ment of gas bubbles, 
which issue from 
their surface. 



Slowly soluble in 
acetic acid, and, af- 
ter a short time with 
the appearance of 
colorless tablets of 
uric acid. 



Insoluble in acetic 
acid. 



Phosphate 
of Li me. See. 



Carbonate 
of Li me. /See. 



Urates. See. 



Molecular 
Granula- 
tions. See 
{ Alga, Bade- 
I ria , Vegetable 
w ' 
brios. 



15 



URI 



URI 



Organized Bodies. 



Cellular 
form,round- 
ish, or oval. 



va- 



Form 
riable, size 
more consid- 
erable than 
the preced- 
ing. 



Cylindrical. 



Globules always f 
round, with smooth or 
jagged outlines, without 
nucleus, more often 
presenting a central 
depression, yellowish, 
isolated, or united in 
coin-like piles, or inter- 
volved in filaments of 
fibrin, or, of mucus. 

Globules round or oval 
with slightly defined 
outline and greyish- 
white contents, granu- 
lar or nucleolated, iso- 
lated or united in 
masses and then poly- 
gonal ; often intervolv- 
ed in mucus and elon- 
gated or expanded. I 
1 Globules round or 
oval, very small, very 
refractive, sometimes 
presenting 1 or 2 brill- 
iant nucleoli or verru- 
cous expansions upon 
their margins, isolated 
or united in bead-form. 
Requiring 500 diame- 
ters. I 

Corpuscles very small, f 
oval, refractive, hya- j 
line, furnished with a 
very long, delicate fil- 
ament. 500 diam. 

Roundish, cylindri- 
cal, fusiform, or poly- 
gonal, with very gran- 
ular contents, or, more "! 
generally furnished 
with one or several nu- 
clei. 

Voluminous, of great- 
er or less length, with 
variable aspect, some- 
times twisted or undu- 
lated. Requiring 120 
diameters. 

Very short and very 
small, transparent, 

more often agitated 
with oscillatory move- 
ments. Requiring 500 
diameters. 



Swell with weak 
acetic acid, or shrink 
up and present a 
raspberry aspect; not 
colored by carmine. 



Rendered pale by 
acetic acid which 
causes 2 or 3 (gener- 
ally 3) nucleoli to 
appear within them. 
Colored by carmine. 



Not changed by 
acetic acid, nor col- 
ored by carmine. 
The nucleoli or the 
interior of the cell- 
ule is colored brown- 
ish-yellow by iodine 
water. 



Unchanged by the 
reagents. 

Rendered pale by 
acetic acid which 
causes it or the nu- 
clei to appear dis- 
tinctly, distorting 
them. Colored by 
carmine, especially 
the nuclei. 



Blood Glo- 
1 bules. See. 



Unchanged by ace- 
tic acid which retards 
or arrests the move- 
ments. 



Leucocytes. 

See. 



Spores. See 

Alga, Fungi, 
VegetableOr- 
ganisms. 



J Spermato- 
zoids. See. 



Epithelium. 

1 See. 



Renal Tube 
Casts. See. 



Bacteria. 
Vibrios. Sec. 



UKI 



227 



URI 



Filaments, 

or 
Fibrillary. 



Very thin, more or 
less ramified or inter- 
crossing. 



Unchanged by acetic J 
acid. \ 

Rendered pale by f 
acetic acid; the fibril- 
lary aspect disap- 
pears and gives place - 
to a swollen, trans- 
parent, amorphous 
mass. 

Rendered more evi- 
dent by acetic acid, 
which gives them a 
punctated or striated 
appearance. 



Algae. Fun- 
gi. See. 



Fibrin. See, 



Mucus. Sec. 



N. B. The various filamentous substances just referred to above must not 
be confounded with the tubes coming from the textile fibres of linen and 
clothing, whether partitioned or not, and which are more or less frequently 
met with in the urine under examination. — Starch grains are in the form of 
roundish, oval, or polygonal, very refracting bodies, with concentric striae, or 
with central punctiform depression, linear or stellated, etc., and almost 
always colored dark blue by iodine water. — Fat, under the form of highly re- 
fracting globules of variable dimensions, is accidentally, but very rarely, met 
vith in urinary sediments. See Starch. Fat. 



UKI 



URI 



tXV. Table. 

Action of Acetic Acid. 

Add to the drop of urine on the glass slide a small drop of acetic acid, 
which must always be in excess; cover with thin glass, and examine under 
the microscope. If the sediment 



Disappears. 



Is modified. 



Remains 
without 
change. 



There may 
appear. 



Dissolving quickly. 



Ammonio -magne' 
sian phosphates. 



< Phosphate of lime. 



Dissolving, but more slowly than the 
preceding. 

Dissolving, with disengagement of 
gas bubbles which issue from the sur- 
face of the deposit. Do not confound 
it with the disengagement of gas which 
often occurs, on treating, under the ■{ Carbonates. 
microscope, an ammoniacal urine with 
acetic acid, in which the bubbles arise 
in the midst of the fluid, and are quite 
large. 

Dissolving slowly, but soon replaced 
by tablets of uric acid. 

Becomes pale; the nuclei, when they 
exist are more evident but deformed. 



Urates. 



Becomes pale, certain urinary cyl- 
inders. 

Becomes pale; swells, the fibrillary f 
aspect disappears. I 

Becomes pale, with the appearance J 
of 2 or 3 nuclei. \ 

Becomes pale and shrunken; some- J 
times, however, swollen. \ 



Epithelia. 

Epithelia. Those 
covered with 
urates. 

Fibrin. 
Leucocytes. 
Blood globules. 
Uric acid. 



{ 

< Oxalate of lime. 

C Spores, alga, veg- 
etable filaments, 
spermatozoids, vi- 
brios, bacteria, mo- 
lecular granula- 
tions. 



Proceeding from the urates, — crys- f 
tals in colorless, transparent, tablets, < Uric acid. 
often disposed in longitudinal series. ( 

Filaments, striated or punctated. ■< Mucus. 



URI 



229 



URI 



XVI. Table. 

Action of Potassa at the Tenth. 

Add to the (fresh) drop of urine on the glass slide, by the paper process 
(named above for applying reagents), an excess of a solution of potassa (1 
part potassa to 10 parts of distilled water). One of the following changes 
may occur in the sediment : 



Bodies dis- 
appear. 



Bodies are 
modified. 



Bodies 

remain 

unchanged. 



Non-organ- 
ized bodies. 



Organized 
bodies. 



Urates; the older the urates the slower the 

action. 
Uric acid; dissolves slowly, so that its pro- 
[_ gress may be watched. 

f Blood globules; will be seen to rupture, and 
instantly dissolve. 
Leucocytes; turn pale, and dissolve rapidly. 
Nuclei of epithelia; turn pale, and dissolve 

rapidly. 
Renal tube casts; turn pale, and dissolve rapid- 
ly. In the granular casts, the granulations 
become disassociated, and float in the fluid 
of the preparation, 
t Fibrin, mucus; turn pale and dissolve, 
f The nuclei disappear; at the same time the 
cellule grows pale, swells, and becomes vesi- 
I cular, its outlines are then so indistinct that 
they can be seen only by the aid of oblique 
light. — Pavement epithelia resist the action 
[ of the potassa the longest, 
f Ammonio-magnesian phosphate. 



Epithelia. 



ized bodies. 



Phosphate of lirne. 



Organized 
bodies. 



I 



Carbonate of lime. 
Oxalate of lime. 
' Spores, vibrios, bacteria (movements are ar- 
rested). 
Spermatozoids. 
Vegetable filaments. 
Molecular granulations. 



For coloring agents, see Ammonia, Carmine, Iodine, etc. 

Urine. Urine is a liquid in which is eliminated from the system a large 
proportion of its fluid and solid effete matters, and the quantity of these 
matters vary according to the variations occurring in the vital processes of 
the body. Healthy urine is composed of animal and saline substances, which 
have been separated from the blood by the kidneys ; it is of a clear amber 
color, transparent, acid, reddening litmus paper, has a mawkish, aromatic, 
violet-like odor, frequently changed, however, by articles of diet, a saline, 
bitter, and rather disagreeable taste, a temperature on being passed from 92° 
to 100° F., and a specific gravity from 1.002 to 1.030, depending somewhat 
upon the amount of fluids taken. See Specific Gravity. One thousand parts 
of urine, contain the following constituents, the proportions of which, how- 
ever, vary, according to the circumstances and influences to which the person 
ifl subjected : Water 938; urea 30; creatine 1.25; creatinine 1.50; phosphate 



URI 230 UEI 

of soda, acid phosphate of soda, phosphate of potassa, phosphate of lime, 
phosphate of magnesia, 12.45; coloring matter, mucus, .30; chloride of 
sodium, chloride of potassium, 7.80; urate of soda, urate of potassa, urate of 
ammonia, 1.80; sulphate of soda, sulphate of potassa, 6 90. From 600 c. c. 
to 1800 c. c. of urine are passed in 24 hours, holding in solution 38 grms .87 
to 45 grms .35 of solid matters, but which amount of fluid may be increased 
by the ingestion of large quantities of fluid. The urine of infants is mostly 
colorless, inodorous, of low sp. gr. and having but slight reaction on litmus 
paper; on standing, it acquires an odor resembling that of veal broth.— On 
standing, urine at first evolves a urinous odor, succeeded by one resembling 
sour milk, and then one of a fetid, ammoniaco-alkaline character. Its color, 
odor, quantity, transparency, etc., may be greatly altered by diet, medicines, 
exercise, disease, etc. Acidity of the urine is common to carnivorous animals, 
that of the herbivorous is alkaline. A vegetable diet, renders the urine of 
man less acid, neutral, or alkaline, and likewise diminishes its proportion of 
urea. A visible deposit in recently passed urine is abnormal. 

In the examination of urine, nothing definite can be determined unless the 
whole of the urine passed in every 24 hours is collected, preserved, and tested ; 
in addition to which, the different specimens passed at various periods of the 
day should be tested, and examined as to their color, reaction, transparency, 
etc., immediately after their discharge from the bladder, as well as after the 
urine has stood for 10 or 12 hours. The urine of birds, serpents, and insects 
is solid, and, in all animals possessing distinct urinary bladders, it is fluid.— 
The temperature of the urine is regulated by that of the body from which it 
derives its heat ; scalding of the urine does not depend upon a temperature 
of this fluid exceeding that of the body, but upon an acrid condition of the 
urine, or an inflamed condition of the canal through which it is passed. In 
disease, the temperature will be found to vary very much, and this should 
invariably be ascertained from day to day in all serious maladies ; thus, in 
idiopathic tetanus it may rise to 112°.5 F., while in mania previous to death 
it will fall to 77° F. 

When urine is quite clear, but slightly colored, and of but little sp. gr., it 
is termed Thin or Crude Urine ( U. tenue or crue, Fr.) ; the urine following 
large draughts of aqueous or stimulating fluids, is termed the Urine of drink 
(Urina potus, U. de la boisson, U. aqueuse, Fr.). That following two or three 
hours after a meal, is the Urine of digestion or cocted Urine ( Urine cuite, U. 
de chyle, Fr.) ; that passed early in the morning, and which may be consid- 
ered the normal type of urine, Urine of the blood (Urina sanguinis, Fr.). 
And according to the aspect and character of the urine, it has received the 
names ; bilious or icteral, when of a deep yellow color with greenish reflections ; 
chylous, when following digestion ; fatty or oily; febrile or laleritious, when small 
in quantity and high colored ; flocculent, when turbid from the presence of 
flocculi ; jumentous; lactescent or milky, when white and turbid ; phosphorescent 
or luminous; sanguinolent or bloody; thick or mucilaginous, from excess of mucus ; 
turbid or troubled, etc. However these distinctions possess no great practical 



URI 231 URI 

value, further than to indicate the necessity for an analysis, and perhaps to 
give a direction as to the course to be at first pursued in the chemical micro- 
scopical investigation of the urine under consideration. 

The quantity of urine is increased in diabetes, and is diminished in all 
acute febrile and inflammatory diseases, in renal affections, and in dropsy; a 
persistent diminution is an unfavorable indication- More urine is passed in 
cold weather than during warm seasons, from diminished perspiration in the 
former instance, and increased, in the latter. — The color of the urine also 
affords certain indications ; a pale urine from nearly colorless to straw yel- 
low, w r ith the exception of diabetes- contains less urea and solid matters, and 
indicates the absence of acute disease, while a highly colored urine contains 
a large amount of solids and is more or less unfavorable according to its per- 
sistency and the character and intensity of its color. A greenish yellow or 
greenisb brown urine, or yellowish epithelial cells in this fluid, is generally 
due to the presence of bile pigment. A smoky tint is almost an absolute 
diagnostic of the presence of blood. — The froth on urine that is healthy, 
readily disappears; but if it persistently remains, albumen or bile matters 
may be present. Renal casts in urine would indicate the probability of albu- 
men in this fluid ; so would the presence of blood, or pus When there is an 
excess or deficiency of urinary coloring matter, of phosphates of urea, or, of 
uric acid; when urine contains albumen, bile, blood, fatty matters, leucin, 
oxalate of lime, or sugar, some pathological condition of the system should 
always be suspected. — If to an abnormal urine, be added a concentrated solu- 
tion of tannin, boiling it will give a white precipitate if albumen be present; 
a black, if hematin. — When bloody urine is dark red, ammonia will cause it 
to assume a clearer tint, hyacinth rose. In chlorosis, anemia, and certain 
nervous affections, there is an increase of water in the urine, and this fluid is 
limpid, nearly colorless ; there is a diminution of water in profuse perspira- 
tion, diarrhea, cholera, etc., in which diseases the solid elements increase ; in 
the first instance, should sugar be present, the sp. gr. would lead to a sus- 
picion of its presence, — in the latter, a sthenic condition would be known by 
the accompanying acute symptoms. 

Urine Ferment. KuLney Ferment. A substance to which M. Bechamp 
has given the name of " nephrozymasis." It is, according to him, the albu- 
minoid ferment material of urine, which is obtained from various specimens 
mixed with calcareous, and magnesian, earthy phosphates. Its presence has 
been demonstrated by the property it possesses of fluidifying and saccharify- 
ing starch, the same, as diastase and sialazymasis. It exists in the normal 
urine of both sexes in variable quantity, up to about 9 Troy grains for each 
quart of urine, being more abundant in infancy ; under the influence of ani- 
mal diet; and also, of exercise. In man, its average amount is about 8h 
grains in 24 hours ; in woman, about 6 grains. It has also been met with, 
but in smaller quantity, in the urine during pregnancy, in certain pathologi- 
cal conditions, acute as well as chronic, and even in albuminuria. M. L. 
Leblond has also observed it in affections of the nerve centers. That it is a 



URI 



232 



URI 



different substance from albumen and albuminose is evident from its presence 
in normal urine during the healthiest condition of the body, and less fre- 
quently during pathological conditions. Again, while urine containing a 
large amount of albumen exerts no action upon starch, yet, if, in such a urine, 
this ferment is present, it will dissolve starch placed in contact with it, in a 
short time. The extreme variation in amount of this proteic substance, both 
during the state of health and that of disease, has not yet been satisfactorily 
accounted for. MontpeUier. Med. 

llrinometer. The urinometer is an instrument designed for determining 
the specific gravity of urine, and although not strictly accurate, it is suffi- 
ciently so for practical purposes. The urinometers met with in commerce 
are sold at very low prices, but, as the rule, they are inexact and not fit for 
use, giving no reliable data whatever. (See Fig. 37.) The best urinometers 
are those of Dr. Pile, Philadelphia, Penn.; Mr. Ackland, 
Fig. 37. London; M. Bouchardat, Paris; and the German instru- 

ments, which have two spindles, one ranging from 1.000 to 
1.020, the other from 1.020 to 1.040, by N. Niemann, of Al- 
feld. The of the graduated scale gives the specific gravity 
of distilled water = 1,000. When the instrument is placed 
in the urine contained in a solution tube, or in any cylindri- 
cal vessel of sufficient length and diameter, it sinks to a 
certain number which will be found on a level with the sur- 
face of the fluid, and to which number 1,000 must be added 
to obtain the sp. gr. Thus, if the urinometer sinks until 30 
of the graduation is on a level with the surface of the urine, 
its sp. gr. will be 1,030. As the sp. gr. of a fluid increases 
at a lower temperature, and decreases at a higher, these in- 
struments are constructed for use at a certain temperature, 
60° F., or 15° 5' C; hence the urine to be tested should al- 
ways be artificially brought to a temperature of 60° F. ; 
when attempting to determine its specific gravity. A low 
sp. gr. indicates a maximum of water and a minimum of 
solids; while a high sp. gr. indicates a maximum or an in- 
creased amount of solids, as, urea, sugar, albumen, etc. In 
cases where the temperature of the urine is elevated, and 
can not be readily reduced to 60° F., the following table has 
been given by Mr. Ackland, for correcting the sp. gr. Thus, 
suppose with urine at 80° F., the urinometer gives a sp. gr. 
of 1.018 ; we add to this the amount found opposite 80° F., which is 1.90, 
and this will give a more correct sp. gr. of 1.019.9 ; and so on. 




Urinometer. 



UKI 



233 
XVII. Table. 



URI 



Temperature. 


Amount to 
be added. 


Te 


mperature. 


Amount to 
be added. 


F. 


c. 




F. 


C. 




60 


15.55 


.00 


73 


22.78 


1.20 


61 


16.11 


.08 


74 


23.33 


1.30 


62 


16.67 


.16 


75 


23.89 


1.40 


63 


17.22 


.24 


76 


24.44 


1.50 


64 


1778 


.32 


77 


25.00 


1.60 


65 


18.33 


.40 


78 


25.55 


1.70 


66 


18.89 


.50 


79 


26.11 


1.80 


67 


19 44 


.60 


80 


26.67 


1.90 


68 


20.00 


.70 


81 


27.22 


2.00 


69 


20.55 


.80 


82 


27.78 


2.10 


70 


21.11 


.90 


83 


28.33 


2.20 


71 


21.67 


1.00 


84 


28.98 


2.30 


72 


22.22 


1.11 


85 


29.44 


2.40 








86 


30.00 


2.50 



To use the urinometer, select a solution tube or cylindrical jar, in which the 
instrument will readily move, and place in it enough of the urine, at a 
known temperature determined by a thermometer. By pouring the urine 
carefully, froth will not be apt to form ; but should any be present, it will 
attach itself to the stem of the urinometer, and prevent the exact degree 
marked from being distinctly seen, and may be removed either by blotting 
paper, or by completely filling the jar. letting it rest a few seconds, and blow- 
ing away the froth at the same time that we incline the vessel to decant the 
superfluous amount of urine. Now, introduce the urinometer into the urine 
and allow it to gradually sink into this fluid, until it will no longer descend 
spontaneously. To make certain that it has passed down to its proper level, 
gently press a finger upon the top of the stem, so as to cause it to sink still fur- 
ther about one degree only, no more, and then allow it to rise by removing the 
finger. If it be pressed downwards too far, its stem, becoming covered with 
urine, will be rendered heavier, and thus produce an error in the determina- 
tion. The instrument must also be kept free from contact with the walls of 
the jar. The degree should be read off by looking at the graduated mark 
through the urine ; that mark should be taken which is on a level with the 
surface of the fluid, and not that which is shown by an accumulation of the 
urine around the stem.of the instrument, as this would give too high a sp. gr. 
In this reading the eye should be brought upon a line with the surface of the 
liquid. 

It must be remembered that the specific gravity of urine varies according 
to the weight and age of the person, the quantity of the solids or fluids taken 
into the stomach, and the amount of exercise. A decreased amount of urine, 
with a slightly increased degree of sp. gr., does not necessarily indicate 
disease, and vice versa. The greater the amount of tissue destruction, the 



URO 234 URO 

greater will be the quantity of solids in the urine (urea), and the higher will 
be the specific gravity. Dark-colored, scant urine is generally of high sp. 
gr.; while in pale urine, or when augmented in quantity, with the exception 
of diabetic urine, the sp. gr. is low. See Pycnometer; Solids in Urine; Specific 
Gravity. 

Urobiline. A name given to the coloring matter of normal urine. Jaffe 
has obtained it by adding a large amount of ammonia to the urine, filtering, 
and adding chloride of zinc until a precipitate is no longer produced. This 
reddish precipitate is successively washed with cold water, then with warm, 
until the washings become no longer turbid by addition of nitrate of silver; 
then the precipitate is treated with boiling alcohol, and dried at a slightly 
elevated temperature. The pulverized mass is dissolved in ammonia, and the 
colored solution precipitated by acetate of lead. The red precipitate thus 
obtained washed with cold water, dried, and decomposed by alcohol contain- 
ing sulphuric acid, yields the urobiline to this liquid. 

Urochloralic Acid. The provisional name given by Musculus and De 
Merme to an acid found in the urine of persons who have taken considerable 
chloral hydrate ; it appearing that chloral, similar to benzoic acid becomes 
materially changed in the organism, to a greater or lesser extent, being 
passed per urine in the form of a strong acid, which rotates polarized light 
to the left, decomposes carbonates with effervescence, reduces solutions of 
copper, silver, and bismuth salts, decolorizes sulphate of indigo, is soluble in 
water or alcohol, insoluble in ether, forms a precipitate of stellated crystals, 
insoluble in water, on the addition of basic lead acetate, and is stated to con- 
sist of 31.60 C, 4.36 H, 26.7 CI. As much as 10 or 12 grammes of this acid 
have been found to exist in each litre of the urine. 

Uroclirome. A name given to a coloring matter of urine by Dr. Thudi- 
cum. According to Dr. T., it may be isolated in a state of purity, forming 
an amorphous substance, yellow, very soluble in water, less so in ether, and 
still less in alcohol. An increase of urochrome in the watery solution still 
occasions a yellow, not blackish color. Tt apparently has no immediate rela- 
tion with the coloring matter of the blood, nor with that of bile, and is a 
derivative of the albuminous matters. Upon analysis it yields a red resin, 
principally consisting of uropittine (C 6 H 10 N 2 3 ), and omicholic acid 
mixed with undetermined dark matters of uromelanin (C 6 H 7 N0 2 ), and other 
products. Probably by a simple process of oxidation, urochrome passes into 
the state of red coloring matter (uroerythrin) which sometimes colors the 
urine of patients without any trace of urates; this change is often effected 
after the micturition. This red coloring may likewise be due to omicholic 
acid, slightly soluble in the ammoniacal salts. The odor of acid or alkaline 
urine is due to the uropittine and omicholic acid, or, to the bodies derived 
from them. Carbonate of ammonia may increase them, but never originates 
them. — One of the first characters of uremia is retention of the urochrome, or 
of the uropittine and omicholic acid in the blood, which vitiates all the tis- 
sues, and may be found in the crusts of the teeth ; their odor is also perceived 



URO 235 URO 

in expiration, and in the perspiration. In this condition typhoid symptoms 
are present. The treatment by aeids promotes the retention of these toxic 
substances in the circulation, and should be replaced by an alkaline treat- 
ment; the skin should also be bathed, and the cutaneous functions attended 
to, until all the odor of uropittine has disappeared. See Hcemochromogene. 
Urohematin. 

Urocyanin. Urocyanogen. Urocyanose. See Uroglaucin. 

Uroerythrin. Urerythrin. Purpurin. The names given to a red coloring 
(acid) matter of the urine, which gives to this fluid and its sediment a dark 
red, brick color. It is often found associated with urophein, and its presence 
always indicates a morbid condition. It is met with in rheumatic and 
periodic fevers, arachnitis, and in very acute inflammations of the meninges, 
which enables us to diagnose this from typhus in which disease this pigment 
is absent. It is, probably, only a modification of urophein. — To determine its 
presence, into 10 c. c. of the urine let fall several drops of solution of acetate 
of lead, which precipitates the urates, sulphates, and phosphates, decolorizing 
the urine at the same time. If, upon standing for 15 minutes, the sediment 
becomes white, uroerythrin is absent ; but if the sediment becomes rose 
colored, this pigment is present, and according to the greater or less intensity 
of the red color will its abundance vary. See Urohematin. 

Uroglaucin. Urocyanogen. Indigo Blue. Cyanourin. The names given 
to a blue, or azure-green pigment, which may be obtained from uroxanthin. 
Under the microscope the blue powder of uroglaucin is found to consist of 
finely pointed needles, occasionally single, but more commonly in stellar 
shape, or in groups having a radiated form. To obtain uroglaucin, mix 10 
c. c. of urine with one-third its volume of ether, and another third of hydro- 
chloric acid. Shake them together for several minutes ; a red, blue or green- 
ish-blue color (uroglaucin) is produced, which the ether carries with it upon 
rising to the top of the fluid in the test tube. According to Kletzinsky, uro- 
glaucin is identical with indigo blue. In Bright's disease, and in cystitis, 
uroglaucin has been observed, being the product of the decomposition of 
uroxanthin in the ammoniacal decomposition of the urine while in the blad- 
der. It is an abnormal pigment, very probably formed from urohematin, and 
to which no satisfactory clinical signification has yet been given, though its 
presence has been supposed to be of an unfavorable character. See Urohema- 
tin. Uroxanthin. 

Urohematin. Urophein. The history of the urinary pigments is so com- 
plicated and obscure," that the most varied opinions have prevailed concerning 
their nomenclature, as well as their origin, character, and semeiotic value. 
Harley, from numerous and long continued researches, strongly maintains that 
all the various urinary colors, are merely different degrees of the oxidation of 
urohematin, the formation of which substance in the human body has been more 
or less influenced and changed by the presence of disease. These colors are 
not always present in the urine when passed, but become subsequently mani- 
fested from the influence of the atmosphere, or the action of certain chemical 



UKO 236 URO 

substances. Urohematin proceeds from the decomposition of the red corpus- 
cles or hematoglobulin of the blood, being more or less abundant in the urine 
according to the more or less rapid disintegration of these corpuscles. And 
his views appear to be rapidly gaining ground among medical men. Parkes 
states " That hematin is almost identical with, and can be changed into, nor- 
mal urinary pigment and into bile pigment, is now generally admitted, and 
the close relationship of indigo to all three is just as certain." Again, "On 
the whole, it does not seem at all unlikely that indigo may be an occasional, 
but not an invariable, product of the metamorphosis of hematin, and that it 
arises from some slight perversion of metamorphosis, the nature of which is 
not yet known." 

Harley gives two methods of determining this pigment in the urine, one 
for its presence in normal urine, and the other for its existence in the urine 
in excess. For the first method, the whole of the urine passed in 24 hours is 
mixed, and then diluted with distilled water until it measures 60 fluid ounces 
(1,800 c. c.) (should the 24 hours urine exceed 60 ounces, it must be concen- 
trated to the required amount by evaporation). Of this prepared urine 
place 2 drachms (7.4 c. c.) in a test tube, and carefully add to it one-fourth 
its volume (1.85 c. c.) of chemically pure nitric acid, and then allow the 
mixture to stand for several minutes. If the urohematin is present in normal 
quantity, the" tint of the urine will be but slightly modified ; but if it be 
present in excess, the color will change to pink, red, crimson, or purple, 
according to the amount of this pigment The different shades of coloration 
will be found referred to in VogeVs Tabic of Colors. 

The change of color in this process may be hastened by heat, but it is 
better to employ no heat, and allow sufficient time for the change. The acid 
sets the coloring matter free ; and in this way a very pale, clear urine may 
be found to contain an abundance, while, on the other hand, a high colored 
urine may contain but a small amount of urohematin. If it be required to 
collect the urohematin, a drachm of ether may be added to the above mix- 
ture ; then strongly agitate, and set aside for 24 hours, when the ether will 
be at the top, and of a more or less red color. Decant the ether, evaporate 
to dryness, and treat the residue with chloroform. 

When rapid disintegration of the blood globules is occurring, and an excess 
of urohematin is contained in the urine, the method is to boil 100 or 150 o. c. 
of the urine, and add 25 or 38 c. c. of nitric or hydrochloric acid to it. This 
liberates the coloring matter. When cool, place the urine thus colored into 
a half pint bottle, add to it ether 30 c. c, cork the bottle, agitate the mixture 
strongly, and allow it to stand for 24 hours, when the ether will present the 
appearance of a red, tremulous jelly, should the case be a very bad one. In 
the worst forms, the urine is neutral or alkaline. Sometimes nitric acid 
develops only a yellow color; hydrochloric, always gives the red. 

Urohematin is a bright red, non-crystallizable, soft, sealing waxy, organic 
compound, becoming hard and brittle by age, and having a shining fracture. 
It is soluble in alcohol, chloroform, ether, fresh urine, and caustic ammonia, 



URO 237 URO 

soda, and potassa ; insoluble in pure water, solution of chloride of sodium, 
or chloride of barium, and in hydrochloric, nitric, oxalic, sulphuric, and tar- 
taric acids. A small quantity of it placed on a platinum spatula and burned 
until an ash remains, which ash is then dissolved in weak hydrochloric acid, 
— will give with a drop or two of sulphocyanide of potassium a fine red color, 
and, with a drop or two of ferrocyanide of potassium, a Prussian blue pre- 
cipitate, thus demonstrating the presence of iron. The ash of any urine may 
be treated in the same way. See Iron. Color of Urine. Hematin. 

Clinical Import. Urohematin may be present in abnormal quantity in pale 
urine, as well as in colored. It is present in excess in hysteria, chlorosis, 
dyspepsia, low fevers, pneumonia, diphtheria, and in nervous lesions; and. 
the greater the amount above normal, the more serious is the patient's con- 
dition. In cerebral and spinal disease, it is apt to be present in the urine 
in great excess, associated with a saccharine or phosphatic condition of this 
fluid. The amount of urohematin in the urine will afford an idea of the 
extent and rapidity of the daily disintegration of the blood globules of the 
body ; bearing in mind, however, that certain vegetable foods give rise to its 
presence, and that when it assumes a dark color, it may be due to a local 
destruction of the blood corpuscles, in the liver, the kidney, or in both com- 
bined. Urohematin may exist in a free state coloring the urine red, but this 
fluid, unlike that of hematuria, will be clear and transparent, and devoid of 
blood corpuscles, unless, indeed, the conditions of disorganization of blood 
corpuscles, and local hemorrhage, exist together. As before stated, the vari- 
ous colors of the urine, are chiefly due to the degree of oxidation of the uro- 
hematin, and, as the rule, the darker the color, the more serious the patient's 
condition. The remedies are pyrophosphate of iron, manganese, nux vomica, 
and nerve tonics. — The dark yellow urine from rhubarb and santonine 
assumes a blood-red color when treated with ammonia or potassa. The 
greyish yellow from resin turns blue with perchloride of iron. Campeachy 
wood, and aloes, impart a deep-red color to the urine, and madder, black- 
berries, raspberries, and fruit of cactus opuntia, a pure red, etc. Again, 
according to its degree of oxidation in the urine, urohematin becomes colored 
red, blue, green, yellow, or violet, with nitric, hydrochloric, and sulphuric 
acids. 

Uromancy. Uroscopy. The pretended, charlatanic determination of dis- 
eases by simple inspection of the urine. 

Uromelanin. See Urochrome. Melanin. 

Uropliein. Urophain. Red Pigment of Urine. See Urohematin. (Before 
Harley's determination of the coloring matter of urine, Heller had named it 
urophein, and gave the following method of detecting it: — Into a small 
beaker glass pour 2 c. c. of colorless concentrated sulphuric acid, and then, 
from a height of 3 or 4 inches, gradually pour a very fine stream of the urine 
to be tested, until 4 c. c. have been used. When the fluids are well mingled 
the mixture assumes a more or less dark brown or black color, according to 
the amount of this pigment present. Sugar, blood, bile pigment, and uroeryth- 



UKO 238 UKO 

rin, have the same reaction, hence, they must be removed previous to the 
experiment. Ziegler states that the most intense coloration is present in 
cirrhosis of the liver. An abundance of urophein with a concentrated urine, 
occasions great acidity of the urine, with a sense of burning in urinating. 
Pale and abundant urine is apt to give a neutral reaction. Urophein is 
absent in diabetic urine. It predominates after a full meal, in profuse per- 
spiration, in the decline of acute diseases, and when the urine is quite dense 
and rich in nitrogenized and extractive matters. It is in small quantity in 
chlorosis, anemia, and at the termination of long and serious diseases. It 
abounds in inflammatory fevers. Chronic liver disease, fatty, as well as 
amyloid degeneration, and cirrhosis, may occasion enough urophein in the 
urine to color it brown like Malaga wine). Isolated urophein is brown, acid, 
of urinous odor, and, in contact with the atmosphere becomes rapidly con- 
verted into carbonate of ammonia. When uroxanthin is present in typhus, 
it is stated that the reappearance of urophein is a favorable indication. 

TJrosacine. UiTOsacin. A name given to the yellowish-red coloring matter 
of urine; probably a modification of urohematin. This coloring matter is 
more or less marked according to the greater or lesser amount of the fluid 
element in the urine. 

Uroscopy. See TJromancy. 

Uroses. Maladies pertaining to the urinary apparatus. 
Urostealith. This is a constituent of urinary calculi first observed by 
Heller. When recent, it is soft and elastic like caoutchouc, becoming hard, 
brittle, and wax-like when dried. Calculi have been found consisting of 
pure urostealith, of various sizes, generally about the size of a pea, sometimes 
smaller, at others, a little larger, or, of this substance enveloped by crystals 
of ammonio-magnesian phosphate. When a fragment is heated on platinum 
foil, it remains solid for a time, then fuses, swells, and evolves a pungent odor, 
resembling that of shell-lac and benzoin. In this state, if a flame be applied 
to it, it takes fire, burning with a clear yellow flame, leaving a voluminous 
charcoal, which, when thoroughly burned, leaves a very minute alkaline ash, 
consisting principally of lime. It softens but does not dissolve in boiling 
water; is difficultly soluble in warm alcohol, from which it is recovered in 
an amorphous state on evaporation. Ether dissolves it pretty freely ; it 
is soluble in hot liquor potassa forming a brown soap, and from which it 
may be separated by treatment with an acid. Heated with nitric acid a 
colorless solution is obtained, a slight quantity of gas being evolved ; if this 
solution be evaporated, and the residue treated with ammonia or potassa, a 
dark-yellow color is given to it. As this substance has only been met with 
two or three times, a thorough analysis of it has not been made ; conse- 
quently it has not been positively ascertained whether it is a fat or a resin, 
nor is its elementary composition known. 

Uroxanthin. Indican. Indigose. This substance was obtained from 
urine by Heller. It is a normal coloring matter, yellow, existing in small 
quantity in normal urine, but which may appear in abundance under the 



URO 239 UEO 

influence of disease. Urine is not colored by it, except from its decomposi- 
tion. Under treatment with acids, Heller divided it into a blue coloring sub- 
stance, uroglaucin. and a red one, urrhodin. According to Harley it is one of 
the pigments derived from urohematin. See Color of Urine; Urohematin. — To 
detect uroxanthin, Heller advises to place 4 or 5 c c. of pure fuming hydro- 
chloric acid into a small beaker glass, and while constantly stirring it with a 
glass rod, add to it drop by drop, not exceeding 10 or 20 drops of the urine. 
If an abnormal amount of uroxanthin be present, it is decomposed, and the 
fluid passes from a violet-red up to a blue color. This discoloration of the 
fluid occurs more rapidly as the indican is more abundant; if from the 
small amount of uroxanthin in the urine, the reaction is slow or indistinct, 
it may be rendered more rapid and marked by the addition of 2 or 3 drops 
of pure nitric acid. If bile pigment be also present in the urine, it must be 
removed by precipitation with solution of acetate of lead, and filtration, pre- 
vious to employing the above-named test. — It may also be detected by heating 
a small quantity of urine diluted with a few drops of hydrochloric acid. As 
60on as the mixture becomes heated it will give a violet-red, and then a deep 
blue color, ^hen cold, the coloration occurs very slowly and is not very 
intense. The coloring matter obtained by the action of acids and heat, pre- 
cipitates, when allowed to stand for 24 hours, in a fine powder which, exam- 
ined under the microscope (X 550), consists of very fine roundish, uniform, 
transparent granules, which are agitated with Brunonian movements when 
they are separate or united in irregular, dark-blue patches. 

Prof Senator, of Berlin, adopts a very ready method for the determination 
of indican in the urine, as follows : To 5 or 10 c. c. of the urine, add an 
equal quantity of fuming muriatic acid, if indican be present, a dark-blue 
cloud is produced, frequently at once; this cloud becomes more distinct, if a 
saturated solution of chloride of lime be carefully added, drop by drop. An 
excess of the lime solution decolorizes the blue cloud. Chloroform added 
to the blue urine, combines with the indigo, and precipitates, with it, to the 
bottom o f the vessel. The amount of indigo present can be approximately 
estimated from the degree of the coloration it imparts to the chloroform. 
Prof. S. does not believe that decomposition of food in the intestine occasions 
the presence of indican, as he has observed it to be present in greater quantity 
in cases where but little or no food was contained in the intestine. He has 
found this substance present in the urine, in cases of ileus, peritonitis, gastric 
cancer and other malignant abdominal affections, gastric ulcer, pernicious 
anemia and leucemia, phthisis, atrophy of the kidney, and acute fevers. 

Uroxanthin or indican, like indigo, is colorless, and may be separated from 
urine, forming a clear brown syrupy fluid, readily soluble in water, ether, 
and alcohol ; urine containing it in excess presents no external character that 
would lead to a suspicion of its presence. By decomposition, under the influ- 
ence of boiling acids, as well as of ferments, it yields indigo blue, indigo red, 
and sugar (indigo glucin) as the principal products. It is found in excess in 
the urine of persons afflicted with diabetes, albuminuria, typhus and other 



UKR 240 VEG 

malignant fevers, cholera, pyemia, variola, after coition and sexual excesses, 
and especially in maladies of the spinal cord, and in cancer of the liver. 
The gravity of which diseases is in direct ratio with the abundance of indi- 
can. It is also found in the urine of the dog. 

TCrrhodin. Indigo Red. Indirubin. According to Heller, this is one of 
the products of oxidation (decomposition) of uroxanthin, being, however, 
less oxidized than uroglaucin, and generally found in larger quantity. To 
obtain it from pathological urine, add solution of acetate of lead to the urine 
as long as any precipitate occurs, and then filter ; remove the lead from the 
filtered liquor by hydrosulphuric acid; filter; and boil to free the filtrate 
from the acid. Now, drop this urine, into an equal volume of pure, fuming 
hydrochloric acid, constantly stirring, until the mixture becomes of a dark- 
blue color. (If only a violet or red color is obtained, no deposit of indigo 
will occur.) Let the mixture stand for 12 hours, then add an equal volume 
of cold distilled water, and set aside for 24 hours. Separate the precipitate 
by filtration, wash it with boiling water until the washings have a neutral 
reaction ; then wash with a little dilute alcohol, and dry, on the filter, in a 
drying oven, over sulphuric acid. Wash the precipitate and the perfectly 
dry filter with pure ether, as long as a red-colored filtrate is obtained. This 
ethereal liquor has an acid reaction, and, when evaporated, leaves an amor- 
phous brownish-red resin, which is insoluble in water, but soluble in cold 
alcohol and ether to which it imparts a beautiful carmine-red color (urrhodin). 
From the washed residue on the filter, uroglaucin is obtained, by boiling it 
in alcohol (several successive quantities) as long as a blue colored fluid is 
obtained ; these colored liquors are united, filtered while boiling hot, then 
evaporated to one-half their bulk, and set aside to crystallize. — M6hu, instead 
of acting upon the urine with strong mineral acids, agitates the crude urine 
with ether or chloroform, which removes the coloring matter, especially the 
red. The blue matter, more exclusively in suspension, upon filtering remains 
on the filter, but aided by the red matter it dissolves a little in the ether or 
the chloroform, whence the violet coloration of these liquids. — See Uroglaucin. 
For clinical import, see Uroxanthin. 

Urylic Acid. See Uric Acid. 



V. 

Valerian. Taken internally in large doses, communicates its odor to the 
urine. Valerianic acid is one of the products of the metamorphosis of leucin. 

Vegetable Coloring Matters. When urine, containing a vegetable color- 
ing matter is rendered alkaline by the addition of ammonia, it more generally 
becomes red or crimson, according to the amount of such coloring matter 
present; if it now be acidulated by adding an acid to it, the color becomes 
paler or yellow ; upon again restoring it to an alkaline condition, the red 
color reappears. By this method vegetable coloring matters in urine may 



VEG 241 VEG 

usually be determined from the coloring principle of blood, and of uroery- 
thrin, which do not give these reactions. 

Vegetable Oils. Many vegetable oils impart their own, or a peculiar, 
odor, to urine, as, oils of turpentine, valerian, juniper, garlic, etc. The 
changes they undergo in the system, or the influence they exert upon the 
character of the urine, is yet undetermined. 

Vegetable Organisms. Besides the various organized and crystalline 
elements composing urinary sediments, various vegetable (or animal) organ- 
isms in process of development, are met with. Upon examining an alkaline 
urine under the microscope, especially during summer, very fine, slender 
filaments will be observed crossing each other in an inextricable manner, and 
myriads of specks, or of small rods which move in every direction. In other 
specimens of urine, divers spores (fructifying or reproductory organs) will be 
found, either isolated, grouped, or arranged in lines like strings of beads, and 
belonging to undetermined species of fungi (mucedines). These spores are 
generally roundish or ovoid, very refracting, present a homogeneous, amor- 
phous composition, with or without nucleoli. When these latter are present, 
they are to the number of 1 or 2, rarely more, and are remarkable for their 
brightness. They vary in diameter from the 3 $Vft tfa to the y^TToth of an 
inch. 

All these bodies are of external origin, and have neither interest or signifi- 
cation for the practitioner. But it is important that he should know them, 
to avoid confounding them with other more or less apparently similar ele- 
ments eliminated by the organism. Whenever they are encountered it may 
be concluded that the fluid, under examination, containing them, is under- 
going a change. It is a mistake to suppose that vibrios and bacteria, which 
are vegetable and not animal, may normally exist in the different humors of 
the economy, notwithstanding the fact of their presence in pus, and other 
fluids affected or produced by diseased conditions. Ammonia arrests the 
movements of spirillum, vibrios, and bacteria, without affecting them, while it 
dissolves the substance of infusoria, of which two kinds only are represented 
in human urine. 

Some very minute granulations are daily met with in the urine under 
microscopic examination, which have an uninterrupted dancing or gyratory 
movement, termed the Brunonian molecular movement. These granula- 
tions, frequently called ''proteinous molecular granulations," are either 
isolated and mobile, or united in groups or granular masses. According to 
the recent researches of M. Bechamp, these granules, which he terms micro- 
zymas, are only one of the phases of development of vibrios and bacteria, 
which results from their attachment and union end to end, in thread-like 
chains. Others regard them as the reproductive organs of the algae or fungi. 
M. Hoffman considers them to be products of disaggregation, of organic 
detritus, and not of new organs. Spirillum, vibrios, and bacteria represent 
the various phases of development of filamentous algae (leptothrix and others). 
— The various bodies just noticed are not colored by solution of carmine, and 
16 



VES 242 VOG 

acetic acid makes but little impression upon them. Iodine is the proper 
agent to render them conspicuous (See Solution of Iodine, No. 1). It colors 
their tissue yellow, arrests their movements, and colors the contents of the 
tubes of leptotbrix, without acting upon its external envelop. — Salicylic 
acid, as well as thymol, prevents the growth of these minute organisms, and 
checks fermentation and putrefaction, in urine. See Tables XIV, XV, 
and XVI. 

Vesical Oxide. See Cystine. 

Tibriones. Vibrios. Filiform bodies, more or less distinctly jointed from 
imperfect division, and having an undulatory movement like that of a ser- 
pent. Their length varies from mm .001 to mm .003. See Vegetable Or- 
ganisms. Vibriones are met with in the pale urine of cachectic and debili- 
tated persons, and in the urine of persons extremely prostrated by phthisis, 
mesenteric and syphilitic diseases, etc. 

Vitali's Method for Quinia. Dr. D. Vitali states that the following 
process for the detection of quinia in urine is both satisfactory and readily 
practiced : — Into a test tube place 8 or 10 c. c. of the urine, add to it 5 or 6 
c. c. of ether, and then 8 to 10 drops of ammonia.* Agitate the mixture 
thoroughly and set aside. As soon as all the ether forms an upper layer 
upon the fluid, remove it by means of a small pipette, place it in a small cap- 
sule, add a drop of diluted pure hydrochloric acid to it, and evaporate by a 
gentle heat. When cool, place a drop or two of saturated chlorine water in 
the capsule, and by means of a glass rod rub up all the hardly visible residue 
on the sides and bottom of the vessel, and then add a drop of ammonia. 
The characteristic green color will be produced if the urine contains yoow tn 
part of the alkaloid. If a drop of yellow prussiate of potassa be added to 
the residue left by the evaporation, and then a drop or two of chlorine 
water, followed by a trace of ammonia, a reddish-purple color will be 
produced. 

* Dr. Vitali prefers, at this stage of the process, the employment of a solution 
of caustic soda 1 part to 60 parts of distilled water, — instead of the ammonia. 

Voxel's Table of Colors. This is a very ingenious and valuable mode 
of determining, approximatively, the quantity of coloring matter in the 
urine, prepared by Dr. Vogel after having made a large number of compar- 
ative observations ; it is well adapted for the purposes of the medical man, 
enabling him to ascertain the amount of urohematin or coloring matter 
present in any specimen of urine. These colors are divided into three 
groups, viz., yellowish, reddish, and brown urines, and although there may 
be intermediate colors, yet these nine will be found sufficient for bedside 
investigations. As the absolute quantity of urohematin required in a given 
bulk of urine, to produce any one of these colors, is not known. Vogel assumed, 
as a starting point, that in 1,000 c c. of pale yellow urine the pigment should 
be considered as a unit or 1, no matter how much its actual amount might be. 
The same volume, 1,000 c. c. of yellowish-red urine (V) will consequently 
contain 16 parts of pigment, and reddish-brown 128 parts. If, therefore, a 



VOG 



243 



VOG 



person passes in 24 hours 1,000 c. c. of pale yellow urine, and another party 
passes 1,000 c. c. of reddish-brown urine, the former has discharged 1 part of 
urohematin and the latter 128 parts, in equal volumes of urine. Again, if a 
patient passes in 24 hours, 1,000 c. c. of yellow urine, and another, in the 
same time, passes 4,000 c. c. of pale-yellow urine, both have discharged an 
equal quantity of pigment in the same time. Suppose, in 24 hours, 1,800 c. 
c. of yellow urine were passed, how much pigment would this urine contain? 
Now 1,000 c. c. of this colored urine contain, as will be seen by the table, 4 
parts of pigment, hence, 

1,000 : 4 :: 1,800 : x. 

x = 7.2 parts of coloring matter in the 
1,800 c. c. of yellow urine. 

XIX- Table. 
Vogel's Table of Colors. 



I. 


II. 
2 


III. 
4 


IV. 

8 


v. 


VI. 


VII. 


VIII. 

128 


IX. 
256 


Pale Yellow 




1 


16 


32 


64 


= I. 




1 


2 


4 


8 


16 


32 


64 


128 


Light Yellow 


= 11. 






1 


2 


4 


8 


16 


32 


64 


Yellow 


== III. 








1 


2 


4 


8 


16 


32 


Reddish Yellow 


= IV. 










1 


2 


4 


8 


l'i 


Yellowish Red 


= V. 












1 


2 

1 


4 

2 

1 


8 
4 
2 
1 


Red 

Brownish Red 
Reddish Brown 
Brownish Black 


= VI. 
= VII. 
= VIII. 
= IX. 



To obtain uniform results, and render these comparable, it is necessary 
that the urine be absolutely clear, and which, when required, may be ob- 
tained by filtering it. A cylindrical glass jar, of not less than 4 or 5 inches 
in diameter, must be used in this investigation, and the color be ascertained 
by transmitted light. — Books of colored papers, already gummed, represent- 
ing the colors named in the above table, can be had of dealers in chemical 
apparatus, and of many surgical instrument makers; they are useful for re- 
cording the color of specimens of urine passed at various times by an indi- 
vidual, by simply attaching a slice of the colored paper to the minutes which 
every physician should keep of his patients. 

When the color of the urine depends upon the presence of bile pigment or 
other substances, the above table could not, of course, be depended upon ; 
but these cases are rare, and the coloring matter may be detected in most 
instances by the means named in various parts of this work. Occasionally, 
although the color may be present, it will not give the proper amount of 
pigment corresponding with the scale ; yet. according to Vogel, the maximum 
amount of error is one-third or one-fourth of the figures found, and the table 
will be found fully sufficient and satisfactory for ordinary clinical purposes. 



WAT 244 XAN 

In chlorosis, and anemia, the daily amount of pigment may even fall below 
1 ; while in typhoid fever, scarlatinous nephritis, etc., it may amount to 16, 
64, and even 256. 



W. 

Water Doctor. Uroscopist. A name given to a person who pretends to 
diagnose disease by. merely inspecting the urine, without subjecting it to any 
chemical or microscopical examination. 

Wayne's Analysis. For the determination of sugar in the urine, Prof. E. 
S. Wayne, of Cincinnati, Ohio, has proposed the following process: — 1. Pre- 
cipitate the coloring matter, etc., from the urine, by means of a solution of 
neutral acetate of lead (common sugar of lead), and filter. Again precipi- 
tate with a solution of subacetate of lead (basic acetate of lead), and filter. 
To the filtrate add ammonia as long as it occasions a precipitate. Collect 
this precipitate; decompose it with sulphureted hydrogen; filter to remove 
the sulphuret of lead, and evaporate the clear solution, in a water bath, to 
dryness, and sugar remains, if it were present in the urine. 

White Blood Corpuscles. See Blood; Leucocytes. 

Wood Fibre. Fibres of deal occasionally exist in urine, and may be con- 
founded with renal casts. They may enter urine in uncovered vessels, dur- 
ing, or soon after, sweeping an uncarpeted floor, and in other ways. The 
pores of the woody fibres, in some respects, resemble epithelial cells, but they 
are more regular in their arrangement, have a less regular outline, and 
more or less refractive power. The practitioner should make himself thor- 
oughly acquainted with the appearance of the various kinds of wood in 
ordinary use, when present in minute fragments. 

Wool Fibre. Woollen hairs have an appearance of firm cylinders, with 
slight indentations along their margins, together with fine transverse mark- 
ings. They are soluble in liquor potassa or soda, but not in ammoniacal 
solution of copper. Wool becomes colored brown under the action of plum- 
bate of soda, in consequence of the sulphur it contains, while silk remains 
unaffected. 



Xanthin. Xanthic Oxide. Urous Acid. Uric Oxide. This substance was 
first observed by Marcet in a small calculus. It has only been observed 
three or four times in the form of a calculus, and very rarely in urinary 
sediments. It has been found, however, in several of the tissues of the 
system, and appears to be one of the intermediate products of the metamor- 
phosis of protein substances. It possesses two atoms of oxygen less than 
uric acid, one atom of oxygen more than hypoxanthine, and, unlike cystine, 



XAN 245 ZOO 

contains no sulphur. Xanthin, when pure, is a white, non-crystalline, waxy 
organic substance, insoluble in cold water, ether, alcohol, and hydrochloric 
acid, slightly soluble in hot water and acetic acid, moderately soluble in hot 
hydrochloric acid, which on cooling precipitates crystals of the hydrochlorate 
of xanthin, and is also soluble in nitric acid without effervescence, the solu- 
tion leaving, on evaporation, a bright yellow residue, which gives a dark 
purplish-red color when treated with liquor potassa. Alkalies dissolve it, 
from which solutions it is precipitated by acids, in a white powder. Under 
the blowpipe, it crumbles, blackens, gives out an odor like that of burnt 
horn, burns, and leaves a small amount of ashes. It may be obtained from 
urine by digesting the urine in a weak solution of carbonate of potassa, 
which separates the uric acid, and leaves the xanthin undissolved. In cal- 
culi, and in urinary sediments, it presents a yellow color. It has been artifi- 
cially prepared from uric acid, and from guanine. Neubauer states that he 
has procured only about 15 grains of it from 600 pounds of healthy urine. 
The concretions termed "Oriental bezoards," contain a large quantity of this 
substance. Its clinical importance is unknown. 

Xanthopsia. A poisonous substance into which santonin, under certain 
imperfectly ascertained circumstances, is transformed when it has remained 
in the system a certain length of time, and which is supposed to occasion the 
dangerous symptoms often met with from the administration of the former 
vermifuge. Xanthopsin is eliminated by the urine, to which it imparts a 
yellow color, resembling that of this fluid in jaundice. Caustic alkalies 
added to urine containing xanthopsin, cause this fluid to assume a red color. 
The addition of podophyllin, in a purgative dose, to santonin, when the latter 
is administered as a vermifuge, will prevent the formation of xanthopsin. 
Falck. King. 



Z. 

Zoosperms. See SpermoUozoids. 

Fig. 38. 




Litre Bottle. 



246 SUPPLEMENT. 



SUPPLEMENT. 



Albumen. Dr. Wm. Roberts, of Manchester, Eng., has given a new pro- 
cess, observed by us since the preceding pages were printed, for estimating 
albumen in the urine, and which is effected by progressively adding water to 
the urine, and then observing the action of nitric acid upon each dilution, 
until the albuminous opacity gradually diminishes, and finally ceases to 
appear. Thus : Take a clear glass jar, capable of holding 2,000 or 3,000 c. c. 
of fluid ; into this place 5 c. c. of the albuminous urine, and dilute it with 
5 c. c. of clear water. This dilution may be termed the "first degree;" 
add to it some nitric acid, a feAV drops. If opalescence occurs, again add 
another 5 c. c. of water, and again, if necessary, test with nitric acid ; this 
second dilution forms the " second degree." And continue in this manner 
until the acid occasions no reaction after the liquid has stood for 30 seconds, 
but occasions a faint opalescence at the 45th second ; this is the zero point of 
the reaction. Now divide the number of the dilutions or degrees required, 
by the 5 c. c. of urine to which they were added, which will give "the degrees 
of albumen," each degree of which he has ascertained by calculation to be an 
indication of .0034 per cent, of albumen. This, multiplied by the degrees of 
albumen will give the per cent, of albumen in the urine tested. Suppose 
1,200 c. c. of urine to be passed in the 24 hours, 5 c. c. of which required 1,250 
dilutions before the zero reaction was attained; then 1,250 -=- 5 = 250 X 
.0034 = 85 per cent, of albumen. Now as this albumen in 1,200 c. c. of urine 
is to be determined, we find that Wo 9 " X -85 — 10.2 grammes of albumen in 
this urine of 24 hours. This method appears to be applicable to all albu- 
minous urines, and requires less time and trouble than other quantitative 
processes. The nitric acid may not require to be added after each dilution, 
but only from time to time during the operation. Medico-Chir. Trans. Vol. 
XLI. 

Uroxantbin. Indican. Prof. Senator, of Berlin, in a careful examina- 
tion of the urine in more than 100 cases of various diseases, has found the 
presence of indican in this fluid, more frequently in chronic than in acute 
diseases, and especially in wasting diseases, as, in pththisis, innutrition, dif- 
fuse peritonitis, pneumonia, meningitis, pleurisy, typhoid fever, chlorosis, 
progressive pernicious anemia, leucaemia, multiple glandular swellings with 
children, rickets, and particularly in cancer of the stomach, multiple lympho- 
mata, lympho-sarcomata, tabes mesenterica, amyloid degeneration of the 
liver, spleen, and kidneys, and granular kidney. In many of these cases, 
the presence of indican was accompanied by an increase of lime in the urine. 



SUPPLEMENT. 247 

His process for detecting the presence of urine, was to free it from albumen, 
and then to carefully mix 10 or 15 c. c. of it, in quite a large glass, with an 
equal volume of fuming hydrochloric acid. Now, add gradually, drop by 
drop, a concentrated solution of chloride of calcium, until the indigo-blue 
color is fully developed, and agitate the whole with chloroform, which takes 
up the freshly precipitated indican, and sinks with it to the bottom of the 
liquid. Its amount can 'now be accurately estimated. Pale urine is the 
richest in this substance. Highly colored urine requires to be first decolor- 
ized by acetate of lead (avoiding an excess of this salt), previous to employing 
the above named tests. Med. Tones and Gaz. 1877. 

Xantbaria. A term applied to that peculiar condition of the system in 
which xanthin is present in the urine. 



248 



APPENDIX. 



APPENDIX. 



M. Bouchard at has given the following tables for correcting the specific 
gravity of urine at certain temperatures, and which are based upon the fact 
that urinometers are graduated at the temperature of 15° C. Thus a urine 
at the temperature 28° C, giving a specific gravity of 1.021, will require 2.5 
to be added to it, making its sp. gr., 1.023.5 ; or if it be saccharine urine, 
it will require 3.1 to be added, making the sp. gr. 1024.1, and so on. 



XX. Table. 
Corrections for Non-saccharine Urine. 



To Subtract from the Degree Obtained. 


To Add to the Degree Obtained. 




SPECIFIC 




SPECIFIC 


TEMPERATURE. 


GRAVITY. 


TEMPERATURE. 


GRAVITY. 


Cent. 


Fah. 




Cent. 


Fah. 







32 


0.9 


15 


59 


0.0 


1 


33.8 


0.9 


16 


60.8 


0.1 


2 


35.6 


0.9 


17 


62.6 


0.2 


3 


37.4 


0.9 


18 


64. 


0.3 


4 


39.2 


0.9 


19 


66.2 


0.5 


5 


41 


0.9 


20 


68 


0.7 


6 


42.8 


0.8 


21 


69.8 


0.9 


7 


44.6 


0.8 


22 


71.6 


1.1 


8 


46.4 


0.7 


23 


73 


1.3 


9 


48.2 


0.6 


24 


75.2 


1.5 


10 


50 


0.5 


25 


77 


1.7 


11 


51.8 


0.4 


26 


78.8 


2.0 


12 


53.6 


0.3 


27 


80.6 


2.3 


13 


55.4 


0.2 


28 


82.4 


2.5 


14 


57.2 


0.1 


29 


84.2 


2.7 


15 


59 


0.0 


30 


86 


3.0 








31 


87.8 


3.3 








32 


89.6 


36 








33 


91.4 


3.9 








34 


93.2 


4.2 








35 


95 


4.6 



APPENDIX. 

XXI. Table. 
Correction for Saccharine Urine. 



249 



To Subtract from the Degr 


ee Obtained. 


To Add 


to the Degree 


Obtained. 


TEMPERATURE. 


SPECIFIC 
GRAVITY. 


temperature. 


SPECIFIC 
GRAVITY. 


Cent. 


Fah. 




Cent. 


Fah. 







32 


1.3 


15 


59 


0.0 


1 


33.8 


13 


16 


60.8 


0.2 


2 


35.6 


1.3 


17 


62.6 


0.4 


3 


37.4 


1.3 


18 


64.4 


0.6 


4 


39.2 


1.3 


19 


66.2 


0.8 


5 


41 


1.3 


20 


68 


1.0 


6 


42.8 


1.2 


21 


69.8 


1.2 


7 


44.6 


1.1 


22 


71.6 


1.4 


8 


46.4 


1.0 


23 


73 


1.6 


9 


48.2 


0.9 


24 . 


75.2 


1.9 


10 


50 


0.8 


25 


77 


2.2 


11 


51.8 


0.7 


26 


78.8 


2.5 


12 


53.6 


0.6 


27 


80.6 


2.8 


13 


55.4 


0.4 


28 


82.4 


3.1 


14 


57.2 


0.2 


29 


84.2 


3.4 


15 


59 


0.0 


30 


86 


3.7 








31 


87.8 


4.0 








32 


89.6 


4.3 








33 


91.4 


4.7 








34 


93.2 


5.1 








35 


95 


5.5 



250 



APPENDIX. 

XXII. Table. 
Diagnosis of Blood in Urim 



LOCATION, DISEASE, 
ETC. 


Blood Passed. 


character of urine. 


PAIN, ETC. 


From Kidneys. 


Bloody urine, with 
elongated clots from 
ureters, is generally 
albuminous — usually 
tube casts present, and 
symptoms of renal dis- 
ease. Blood brown 
colored, or like porter, 
and not as profuse as 
when from the blad- 
der. 


Urine smoky or 
blackish -brown, if 
acid ; bright red, if 
alkaline. Forms a 
brownish-red pulver- 
ulent mass or deposit. 
Albumen is present, 
as well as renal casts. 


Pain when moulds 
of clotted blood form 
in the ureters, and are 
discharged in the 
urine. 


Nephritic Colic. 


Frequently bloody 
urine from kidneys. 


Constant desire to 
urinate. Sometimes 
containing bloodclots. 


With pain in region 
of kidneys, and along 
the course of the ure- 
ters. 


Renal Cancer. 


Frequent and pro- 
fuse bloody urine. 


Pus and encepha- 
loid matter present, in 
the advanced stages. 


Tumor found in the 
loins; and deep-seated 
pains. 


From Bladder. 


Blood in small flaky 
clots, not mixed with 
the urine, but passing 
with it. 


Urine ammoniacal ; 
with tenacious mucus 
and phosph?tic depos- 
its in feeble persons. 
Urine alkaline. 


Dull pain in region 
of bladder, and at its 
neck; apt to have fre- 
quent desire to urin- 
ate. Sometimes re- 
tention from a coagu- 
lum in the urethra. 


Abrasion, or Ulcer- 
ation of the Blad- 
der. 


Blood mixed with 
mucus or pus in the 
urine. 


Frequent desire to 
urinate, and urine fe- 
tid, containing more 
or less muco-purulent 
matter. 


Acute burning pain 
in pelvic cavity, with 
uneasiness. 


Malignant Disease. 


Blood dark colored, 
with putrid offensive 
matters. 


Urination often dif- 
ficult, painful, and 
with frequent desires 
to void the urine. 


More or less severe 
pain in vicinity of the 
disease. 


Fiom the Urethra. 


Blood coming with- 
out the urine, in drops 
or in a small stream. 
Sometimes small clots. 


The first jet of urine 
only is bloody, the 
balance becoming 
clearer, and natural. 


Perhaps soreness at 
the part from which 
the blood issues. 


Vesical Calculus. 


Blood in urine after 
exercising; or a drop 
or two, with pain, in 
the last expulsive ef- 
fort at urination, and 
with pain at the time. 


Urine passed often 
during the day; apt 
to be of a florid color; 
and the desire to uri- 
nate caused by any 
movements or exer- 
cise. 


Pain in penis or per- 
ineum felt after (and 
often before) urinat- 
ing, especially when 
the pain is increased 
by exercise. Usually 
the pain is at the end 
of the penis. 


Probably Prostatic 
Hypertrophy. 


Blood intimately 
mixed with urine, dark 
colored, and not much 
altered by circum- 
stances. 


Urine frequent; es- 
pecially during the 
night. 


More or less con- 
stant irritation, at 
neck of bladder. 


Chronic Cystitis, or 
Chr. Inflm. Neck 
of Bladder. 


Urine contains blood 
corpuscles, if any hem- 
orrhage be present. 
Mucus in increased 
amount. 


Urine frequent and 
in small amount dur- 
ing the day (frequent- 
ly alkaline, fetid). 


Pain low down in 
the belly. Slight pain 
in expelling the last 
drops of urine. 



APPENDIX. 



25] 



LOCATION, DISEASE, 
ETC. 


BLOOD PASSED. 


CHARACTER OF URINE. 


PAIN, ETC. 


Chronic Prostati- 
tis. 


Blood rarely,if ever, 
passed. 


Urination unduly 
frequent; a small mu- 
co-purulent discharge 
from urethra; urine a 
little cloudy. 


Diminished sexual 
desire. Pain at end 
of penis. Dull pains 
in perineum and vi- 
cinity. 


Distended Mucous 
Membrane of 
Bladder. 




Urine difficult and 
incomplete; passes by 
drops involuntarily, 
but in full stream by 
catheterization. 


Pain in penis or per- 
ineum, felt before uri- 
nating. 


Chronic Inflm. of 
Mucous Coat of 
Bladder. 


Blood occasionally 
observed, especially 
when ulcerations or 
abcesses have formed. 


Urine passed often 
during the day (over 
5 or 6 times), in small 
quantities at a time; 
alkaline. Mucus in- 
creased. 


Dull pain in region 
ofbladder. Heaviness 
in perineum; weak- 
ness in back. 



N. B. — Always have the urine passed into two vessels — say an ounce or 
two in the first, and the balance in the second. Examine only what is found 
in the second vessel. 

In cold weather, urates are deposited in urine in which none would be seen 
in summer. If the thickness or turbidity of the urine be due to urates, the 
application of a little heat will clear it up- -which is never the case when it 
is due to pus, mucus, or other organic matters. 

When the urates do not appear habitually, it amounts to nothing; only 
when they are heavy and constant, in which case correct the patient's habits 
and digestion, and check indulgence in diet. 

Examine for albumen, sugar, etc.; and in all cases pass a bougie, gently 
and carefully. 

Weights and Measures. 

To facilitate investigations, it has been deemed useful to give some of the 
French Metrical Weights and Measures, their conversion into American, and 
vice versa. It is an excellent plan for every investigator to make these reduc- 
tions and calculations for himself, and to figure them on a pasteboard, of easy 
access. This can readily be done as follows : 

I. One milligramme = .015434023453 Troy grain. 
One centigramme = .15434 + Troy grain. 

One gramme = 15.434 -j- Troy grains. 

Now, to determine fractions of these weights, divide the Troy grains by the 
fraction ; thus, T a 5 th of one milligramme is ascertained by dividing .015434 -f- 
by 45 = .000343 Troy grain. 

To determine any increase of these weights, multiply by the number ex- 
ceeding the unit; thus, 15 centigrammes = .15434 -| 15 = 2.315 -f- Troy 

grains. The same course may be pursued for the determination of the Amer- 
ican measures in the following: 

One millimetre = .0393707904 English inch. 

One centimetre = .393707904 English inch. 

One metre = 39.3707904 English inch. 



252 



APPENDIX. 



One millilitre or c. c. = 16.2319 Minims. 
One centilitre = 162. 3 190 Minims. 

One litre =16231.90 Minims, or 

2 pints, 1 fl. ounce, 6 fl. drachms, 6.32 minims. 
N. B. A millilitre, a gramme, and a cubic centimetre, each, = .061028 
cubic inch, 15.434 Troy grains of distilled water, and 16.2319 minims, Apoth- 
ecaries measure. 

II. One Troy grain = 64.79895 
6.47989 
,06479 
One English inch 
One cubic inch 



milligrammes, or, 
centigrammes, or, 
gramme. 

= 25.3995408 millimetres. 

== 16.3861758 millilitres, or, c. c. 



One Apoth. minim = .0616052 millilitres. 
The French Metrical value of any of these American measures may be 
found, as in the preceding case, by multiplying the metrical measures by the 
increased amount of American measures, or, dividing them by the fractions ; 



grammes. — The long array of figures given in the milli-con versions is rarely 
employed, though stated here for the benefit of those desirous of knowing 
them. For instance, the reduction of hundred-thousandths of an inch into 
millimetres, is sufficiently accurate for all ordinary purposes, by dividing 



Then 



inch 



the fractions of the inch into 25.399541 millimetres. 
.0000634 millimetres. 

The metrical weights and measures, whether they be grammes, metres, or 
litres, etc., bear the following proportions to the unit (that is, to 1 gramme, 
1 metre, 1 litre), according to their prefix: 



Myria- 


Kilo- 


Hecto- 

100 


Deca- 

10 


Gramme, 
Metre, 
Litre. 


Deci- 


Centi- 


Milli- 


10000 


1000 


1 


l 
T(7 


l 
To7 


ToW 


10000.0 


1000.0 


100.0 


10.0 


1. 


.1 


.01 


.001 



A decigramme is j^th of a gramme, a centigramme is xiroth of a gramme, a 
hectogramme is 100 grammes, and so on, whether grammes, litres, or metres. 
The lower line shows the method of dividing and reading the Metrical 
Weights and Measures, from the situation of the decimal dot. Thus, 1. grm, 
or, 1. grm .00, is read as 1 gramme (litre or metre) ; .01 grm is one centi- 
gramme, .001 grm is one milligramme, 10. grms is a decagramme. 1263. 
grms .845 may read, 1 kilogramme, 2 hectogrammes, 6 decagrammes, 3 
grammes, 8 decigrammes, 4 centigrammes, 5 milligrammes; or, it may be 
read as 1263845 milligrammes ( — litres, or — metres). 



APPENDIX. 



253 



XXIII. Table. 
To Reduce Metrical to American Measures. 





Cubic Centimetres, Grammes, or 
Millimetres, to 




Litres, to 




Millimetres, to 




Wine 
Measure. 


Cubic 
Inches. 


Troy 
Grains. 


Wine 
Measure. 


Cubic 
Inches. 


Troy 

Ounces. 


English inch. 




M 






Pints. 








I 


16.2 


.061028 


15-434 


2-1135 


61.028 


32.104 


•03937 


2 


32-4 


.122056 


30.868 


4.2270 


122.056 


64.208 


.07874 


3 


1. 4.9 


.183084 


46.302 


6.3405 


183.084 


96.312 


.11813 


4 


.244112 


61.736 


8-4541 


244.112 


128.416 


•15748 


5 


1. 21. 


.305140 


77.170 


10.5676 


305.140 


160.520 


.19685 


6 


1-37-4 


.366168 


92.604 


12.6811 


366.168 


192.624 


.23622 


7 


153-6 


.427196 


108.038 


14-7947 


427.196 


224.728 


•27559 


8 


2. 9.8 


.488224 


123.472 


16.9082 


488.224 


256.832 


•31496 


9 


2.26. 


•549 2 52 


138.906 


19.0217 


549- 2 52 


288.936 


•35433 


IO 


2.42.4 


.610280 


i54-34o 


21.1353 


610.28 


321.04 


•39371 


20 


5.24.6 
1.0. 6.9 


1.22056 


308.680 


42.2706 


1220.56 


642.08 


.78742 


SO 


1.83084 


463.020 


63.4059 


1830.84 


963.12 


1.18113 


40 


1.2.49.2 


2.44112 


617.361 


84.5412 


2441.12 


1284.16 


1 57484 


50 


1. 5. 31. 6 


3.05140 


771.701 


105.6765 


3051.40 


1605.20 


1.96855 


60 


2.0. I3 .9 


3.66168 


926.041 


126.8118 


3661.68 


1926.24 


2.36226 


70 


2.2.56.2 


4.27196 


1080.381 


147.9471 


4271.96 


2247.28 


2-75597 


80 


2.5.38.5 


4.88224 


1234.721 


169.0824 


4882.24 


2568.32 


3.14968 


90 


3.0.20.8 


5-49252 


1389.062 


190.2177 


549 2 .52 


2839.36 


3-54339 


IOO 


3-3- 3-2 


6.1028 


1543.402 


211,3530 


6102.8 


.3210.4 


3.93710 


200 


6.6. 6.4 
Oct. 

1.0. 7.16 


12.2056 


3086.804 


422.706 


12005.6 


6420.8 


7.87420 


5CO 


30-5I4 


7717.011 


1056.765 


30514.0 


16052.0 


19.68550 


IOOO 


2.1. 6.32 


61.028 


15434.0230 


2113.530 


61028.0 


32104.0 


39-37079 



By the preceding table we may readily reduce metrical figures into Ameri- 
can. Thus, 10 c. c. =154.340 Troy grains, or .610.28 cubic inch. Four litres 
= 8.4541 pints, or 128.416 Troy ounces of distilled water. Ten millimetres 
= .39371 English inch. If we desire to ascertain the equivalent of 15 milli- 
metres, we add together those of 10 and 5, as .39371 + .19685 = .5905. If 
the 30th part of a millimetre is required, divide 1 millimetre, .03937 by 30 
= .00131 Tr. grn.; and so with the other measures. 10,000 c c. requires to 
multiply the equivalent of 1,000 c. c. by 10, which will give, in wine 
measure, 22 pint", 2 ounces, 1 drachm, and 20 minims. If the American 
value of centimetres be required, say 20 centimetres, — as 10 millimetres 
equal one centimetre, we can multiply the 20 cm. by the mm. 200 mm. will 
equal 20 cm.; then 200 millimetres (or 20 centimetres) =7.874 English inches. 



254 



APPENDIX. 



XXIV. Table. 
To Convert American to Metrical Measures, etc. 





Inch to 


Grains to 


Minims to 


Cubic Inch to 




Millimetre. 


Milligramme. 


Millilitres. 


Cubic Centimetres. 


, 


.00254 


.00647 




.001638 


10000 

1 


.00507 


.01295 




* \J\J A. \JKJ\J 

.003279 


70 0~5 

1 


.02539 


!o6479 




.01638 


lTToTf 

Too" 


.*05079 


12958 


........ 


.03277 


1 


.1269 


.32395 




.08193 


T5TS 
T70" 


^2539 


]64791 




.1638 


X 


.2822 


.7199 




.1820 


To 


.3175 


.8099 




.2048 


TO 

1 

¥0" 


.3628 


.9256 




.2341 


.4233 


1.0799 




.2731 


.5079 


1.2958 
1.6198 




.3277 


.6349 


.001 


14096 


1 

TT 


.8466 


2.1597 


.002 


.5462 


K 


1.2699 


3.2395 


.003 


.8193 


tV 


2.5399 


6.4791 


.006 


1.6386 


i 


5.0799 


12.9583 


.012 


3.2771 


i 


6.3498 


16.1979 


.015 


4.0964 


* 


12.6998 

Centimetres. 


32.3959 

Centigrammes. 


.031 


8.1929 


i 


2.539 


6.4792 


.062 


16.3861 


2 


5 079 


12.9583 


.123 


32.7718 


3 


7.619 


19.4375 


.184 


49.1577 


4 


10.159 


25.9167 


.246 


65.5436 


5 


12.699 


32.3959 


.308 


81.9295 


6 


15.239 


38.8751 


.370 


98.3154 


7 


17.779 


45.3543 


.431 


114.7013 


8 


20.319 


51.8335 


.493 


131.0873 


9 


22.859 


58.3137 


.554 


147.4731 


10 


25.399 


64.7989 


.616 


163.861 


20 


50.799 


129.5838 


1.232 


327.718 


30 


76.198 


194.3757 


1.848 


491.577 


40 


101.598 


259.1676 


2.464 


655 436 


50 


126.997 


323 9595 


3.080 


819.295 


60 


152.397 


388.7515 


3.696 


983.154 


70 


177.796 


453.5434 


4312 


1147.013 


80 


203.196 


518.3353 


4.928 


1310 873 


90 


228.595 


583.1272 


5.544 


1474.731 


100 


253.995 


647.'192 


6.160 


1638.617 


500 


1269.977 


3239.5959 


30.804 


8192.951 


1000 


2539.954 


6479.8919 


61.605 


16386.1757 



In the above table, ^th of an inch equals .5079 millimetre; 8 grains equal 
51.833 centigrammes ; 5 minims equal .308 millilitre ; 8 cubic inches equal 
131.0873 cubic centimetres; and so on. How many millimetres are there in 
the ^2Vo tn of an inch? In 3 > 200 there are 16 two hundreds; ^th of an inch 
equals .12699 millimetre; then 16 two hundredths = -iz^j. = .007937 milli- 
metre. Or, it may be done as follows:— J inch = 12.6998 millimetres, — then 
1 inch = 25.3996 millimetres. Therefore, 25.3996 -r- 3,200 = .007937. 



APPENDIX. 



255 



XXV. Table. 
Fop the Conversion of Metrical Weights and Measures into American, 



.01 
.02 
.03 
.04 
.05 
.06 
.07 
.08 
.09 
.1 
.2 
.3 
.4 
.5 
.6 
.7 
.8 
.9 
1. 
2. 
3. 
4. 
5. 
6. 
7. 
8. 
9. 
10. 
20. 
30. 
40. 
50. 
60. 
70. 



90. 

100. 

500. 

1000. 



Millimetres to 


Centimetres to 


Milligrammes 


Inches. 


Inches. 


to Tr. Grains. 


.00039 


.0039 


.00015 


.00078 


.0078 


.00031 


.00118 


.0118 


.00046 


.00157 


.0157 


.00061 


.00197 


.0197 


.00077 


.00236 


.0236 


.00092 


.00276 


.0276 


.00108 


.00315 


.0315 


.0012 


.00354 


.0354 


.0014 


.00394 


.0393 


.0015 


.00787 


.0787 


.0031 


.01181 


.1181 


.0046 


.01575 


.1575 


.0061 


.01969 


.1969 


.0077 


.02362 


.2362 


.0092 


.02756 


.2756 


.0108 


.03149 


.3149 


.0123 


.03543 


.3543 


.0139 


.03937 


.3937 


.0154 


.07874 


.7874 


.0308 


.11811 


1.1811 


.0463 


.15748 


1.5748 


.0617 


.19685 


1.9685 


.0771 


.23622 


2.3622 


.0926 


.27559 


2.7559 


.1080 


.31496 


3.1496 


.1234 


.35433 


3.5433 


.1389 


.39371 


3.9371 


.1543 


.78742 


78742 


.3086 


1.18113 


11.8113 


.4630 


1.57484 


15.7484 


.6173 


1.96855 


19.6855 


.7717 


2.36226 


23.62-J6 


.9260 


2.75597 


27.5597 


- 1.0803 


3.14968 


31.4968 


1.2347 


3.54339 


35.4339 


13890 


3.9371 


39.3708 


1.5434 


19.6855 


196.8539 


7.7170 


39.3710 


393.7079 


15.4340 



Centigrammes 
to Tr. Grains 



Cubic Centime- 
tres; Grammes; 
or Millilitrcs — 
to Wine Meas- 
ure. 

Minims. 



.0015 


.16 


.0031 


.32 


.0046 


.48 


.0061 


.65 


.0077 


.81 


.0092 


.97 


.0108 


1.13 


.0123 


1.29 


.0138 


1.46 


.0154 


1.62 


.0308 


3.24 


.0463 


4.87 


.0617 


6 49 


.0771 


8.11 


.0926 


9.74 


.1080 


11.36 


.1234 


12.98 


.1389 


14.61 


.1543 


16.23 


.3086 


32.46 


.4630 


48.69 


.6173 


f£ 1. 4.92 


.7717 


1.21.16 


.9260 


1.37.39 


1.0803 


1.53.62 


1.2347 


2. 9.85 


1.3890 


2 26.08 


1.5434 


2.42.32 


3.0868 


5.24 63 


4.6302 


il 1.0. 6.95 


6.1736 


1.2.49.27 


7.7170 


1.5.31.59 


9.2604 


2.0.13.91 


108038 


2.2.56.23 


12.3472 


2.5.38.55 


13.8906 


3.0.20 87 


15.4340 


3.3. 319 


77.1701 


16.7.15.95 


154.3402 


33.6.31.90 



In the above table .09 millimetre equal .00351 inch ; .3 centimetre equal 
.1181 inch; .8 milligramme equal .0123 Troy grain ; 3. centigrammes equal 
.4630 Troy grain; 10 c. c, or 10 grammes equal 2 fluidrachms 42.32 minims 
and so on. 



256 



APPENDIX. 



In England, and in this country, the inch is by common consent, taken as 
the standard of measurement ; on the European continent, lines, and parts 
of a line, as well as millimetres are employed for a similar purpose. The 
following tables of comparative micrometrical measures are given, as they 
may be useful for reference : 



Millimetre. 


Paris Lines. 


Vienna Lines. 


Rhenish Lines. 


English 
Inches. 


1 

2.255829 
2.195149 
2.179538 
25.39954 


0.443296 
1 

0.973101 
0.966181 
11.25952 


0.455550 
1.027643 
1 

0.992888 
11.57076 


"0.458813 
1.035003 
1.0071625 
1 
11.65354 


0.0393708 
0.0888138 
0.0864248 
0.0858101 
1. 



The following are given merely to aid in refreshing the mind of the in- 
vestigator : 

To Determine the Magnifying Power of an Objective. 

Multiply the size of the divisions of the stage micrometer by the numera- 
tor of the fraction of parts of an inch it is magnified, and divide this by the 
denominator. Thus, suppose each division of the stage micrometer equals 
■5-^pth of an inch, 1 of which is magnified to T Vths of an inch; then 3^ X 
7 = , 3 5 1 <n) -~ s " 10 = 350 diameters. If 10 divisions are magnified to y^th of an 
inch, then ¥ * T X 7 = 3,500 -h- 10 = 350 diameters, or 10 divisions = 350 di- 
ameters ; and 1 division = 3,500 diameters. Again, the stage micrometer 
divisions equal, each, ^oth of an inch, 1 of which is magnified to If th inch, 
or Yth inch ; then T fo X 11 = 5,500 -*- 8 = 687.5 diameters. 

To Measure an Object with the Eye-piece Micrometer. 

In order to measure an object, the value of the spaces of the ocular micrometer 
must first be had ; and which varies with each objective. This is obtained as 
follows: We find that with an inch objective, three of the divisions of our 
ocular micrometer occupy just one of the stage micrometer spaces, -j^th of 
an inch ; then, when measuring with this objective, an object occupying three 
ocular micrometer divisions, is ^^th of an inch large, or, if it occupies only 
one of these divisions it is xsW-h °f an i» c h. We now remove the inch ob- 
jective, and employ the quarter inch, and find that twenty divisions of the 
ocular micrometer occupy just one of the stage micrometer spaces; then, 
when measuring with this objective, twenty eye-piece micrometer divisions 
are equal to 3-J0 of an inch, and one is equal to the one-twentieth of this, 
or the you 077 °f an inch. And so with all the other objectives. But, sup- 
pose the eye-piece micrometer gives with an objective five and a half divis- 
ions to one of the stage micrometer; we reduce the included divisions of 
the former to halves, which would make eleven, and we then multiply this 



APPENDIX. 257 

by the measure of the one division of the stage micrometer (500), which 
would make -5-5^ inch, equal the half of one ocular micrometer division, 
or Tr ? Vtf inch, the value of one space in this eye-piece. These measurements 
having been once made should be recorded, so as to be ready, for future inves- 
tigations, without any loss of time in renewing them. 

To Determine the Size or Diameters of an Object with any Combination 
of Objectives and Oculars, and without an Eye-piece Micrometer. 

The microscope having been mounted with the required objective and eye- 
piece, attach the camera lucida, and place a stage micrometer on the stage of 
the instrument in the focus of the objective ; then fix the compound body in 
the horizontal position. A sheet of plain paper, or of Bristol card, is now to 
be laid upon the table at the same distance from the center of the eye-glass 
of the ocular as it is from this center to the stage micrometer. Throw the 
image of the micrometer lines upon the card, by means of the camera, and 
carefully mark two, three, or four of them consecutively; divide each of the 
magnified spaces thus obtained between the micrometer lines, into fifths, 
tenths, or twentieths, and, in one corner of this card, record the divisions 
of the stage micrometer used, the focal length of the objective, and the num- 
ber of the eye-piece. This card, with its divisions, will always serve to give 
the measure of any object observed with the same objective and eye- piece, 
when the compound body of the microscope is brought to the horizontal po- 
sition (at the same distances), and the image of the object is, by means of the 
camera, directed upon the graduated lines of said card. If the diameters of 
the observed object are unequal, we may, after having obtained one diameter, 
move the card around as required, so as to obtain the others. — A series of 
these cards should be prepared for each objective with the different eye- 
pieces, and be preserved for future use whenever it is required to measure 
the size of one or more objects. 

It does not matter whether the stage micrometer be ruled into hundredths, 
five hundredths, or thousandths, of an inch, nor what combination of ob- 
jective and eye-piece is employed, the result of the measurement will always 
be the same for each combination, as shown by the following table : 



17 



258 APPENDIX. 

XXVI. Table for Measuring Microscopic Objects. 





Scale 




Scale 
into 
io's. 


Scale 
into 
5's. 


MAGNIFIED MICROMETER i 


=;pace. 


20*S. 


1-2000 inch. 


1-1000 inch. 


1-500 inch. 


1-100 inch. 










80,000 


40,000 


20,000 


4,000 


SB 

© 
M 
S: 

N 

► 

© 

«! 




I 








40, OOO 


20,000 


10,000 


2,000 




2 






26,666 -+- 


13,333 + 


6,666 + 


1,333+ 


I 




20,000 


10,000 


5,000 


1,000 




3 






16,000 


8,000 


4,000 


800 






13,333 + 


6,666+ 


3,333+ 


666+ 




4 






11,428 + 


5.7M+ 


2,857+ 


571 + 


2 


I 


10,000 


5,000 


2.500 


500 




5 






8,888 + 


4,444+ 


2,22* + 


444+ 






8,000 


4,000 


2,000 


400 




6 








7,272 + 


3,636-r 


I,8l8 + 


363 + 


3 




6,666+ 


3,333+ 


1,666+ 


333+ 





8 






6,154— 


3,077— 


1,538 + 


307+ 






5,714+ 


2,857+ 


1,428+ 


285+ 






5,333+ 


2.666+ 


I ,333 + 


266+ 


4 


2 


5,000 


2.500 


1,250 


250 




9 






4,706— 


2,353— 


1,176 + 


235+ 






4,444 + 


2,222+ 


I,III + 


222+ 




10 






4,210+ 


2,105+ 


1,052 + 


210+ 


5 




4,000 


2,000 


I.OOO 


200 




ii 








3,809 + 


1,904 


952 + 


190+ 






3,636+ 


1,818+ 


939+ 


181 + 




12 






3,478 + 


1,739 + 


869 + 


174— 


6 


3 


3,333+ 


1.666+ 


833 + 


166+ 




13 






3,200 


1.600 


800 


160 






3-077— 


1,538 + 


769 + 


153+ 




14 






2,963- 


1,481 + 


74o + 


148+ 


7 




2,857+ 


1,428 + 


7H+ 


142+ 




15 






2,758+ 


J ,379 + 


689 + 


138- 






2,666+ 


i,333+ 


666+ 


133+ 


— 


1 6 








2,380+ 


1,290+ 


645 + 


129+ 


8 


4 


2.500 


1,250 


625 


125 


— 


17 






2,424+ 


1,212+ 


606+ 


121 + 






2,353— 


1,176+ 


588+ 


117+ 


— 


iS 






2,285+ 


1,143— 


57' + 


114+ 


9 




2,222+ 


T,III + 


555+ 


111 + 




19 

20 






2,162+ 


1,081 + 


540+ 


108+ 






2,105+ 


1,052+ 


526+ 


105+ 






2,051 + 


1,025 + 


512+ 


102+ 


10 


5 


2,000 


1,000 


500 


100 



















APPENDIX. 259 

Thus, if a micrometer of v^jth of an inch ruling be employed, it will be 
manifest that, if the magnified image of one of its spaces on the card be 
divided into twentieths, one of these divisions will invariably give the meas- 
urement of juihnsth °f an i ncn ; while twelve and a half of these divisions 
will give y^nfth of an inch; and so on. This will be found in the table, by 
referring to the column under the heading, " ^joth inch," and that of "Scale 
into 20's." — If the micrometer space on the card be divided into tenths, by 
referring to the table, in the column under the heading, ''Scale into 10's," 
we find one of these spaces, for a ^th inch micrometer, equal to a6 g 60 th of 
an inch; while five and one-fourth spaces equal -j^o 9 + th of an inch. — If the 
micrometer be ruled into -j-Joths of an inch, and the magnified image of one 
of its spaces, on the card, be divided into twentieths, upon referring to the 
columns in the table, under the heading "-5^0 inch" and "Scale into 20's," 
we find that one of these spaces equal xolroo^ 1 of an inch; and six and one- 
half of them equal xsV^-ftb. of an inch. But if the spaces are divided into 
fifths, we must refer to the column under the heading " Scale into 5's," and 
then run along the horizontal line until we come to the column for "3^ 
inch," in which we will find one of these spaces equal to ^Voth of an inch; 
and four and one-eighth of them equal to girg-fth. of an inch. — If the image 
of T ^jth inch micrometer have its spaces between two lines divided into fifths, 
by referring to the column under "Scale into 5's," and following out horizon- 
tally to the column for "y^th inch," we find one space equal to -5^0^ of an 
inch ; and four spaces equal to T^th of an inch ; and so on. — If the stage 
micrometer be ruled into 2Fo*hs °^ an i nc h, we have simply to double the 
figures given for that of y^^hs of an inch. 

Whenever the magnified space between any two micrometer lines is divided 
into twentieths, we must refer to the column in the table under the heading 
"Scale into 20's;" if into tenths, to that under "Scale into 10's;" and if into 
fifths, to that under " Scale into 5's;" ascertaining the amount of measure- 
ment of one or more of these divisions, in the columns under the headings 
swjth, xoVffth, 3iyo th > or TTo th inch, according to the ruling of the microme- 
ter used. When — is placed after any figures, it means that the measure- 
ment is slightly less than given ; and -(-, that it is slightly above ; in either 
case to an almost inappreciable amount. — To reduce the fractional parts of 
an inch into millimetres, divide them into 25.399540871 ; then ^o^oo^h- of an 
inch equal to .00063498 -f millimetre. 

To Reduce Compound Fractions to Simple Ones. Multiply the numerators to- 
gether for a new numerator, and the denominators for a new denominator. 
What is the if of ^oVo? 

^U X 2o OS" — ¥0 QTT5 — TToS'TS +• 

What is the I of T ^? 

t X Ttftf 



260 APPENDIX. 

To Reduce Decimals to Fractions. Place the denominator under the decimal, 
and reduce this fraction to its lowest term ; thus — 
Reduce .225 to fractions. y 2 ^ = ¥ %. 
Reduce .059375 to fractions. T °#oVo 5 o = i¥o : or, T %Wo\% -*• 25 = ^oVV 

_;_ OK 95 _i_ K 19 

— AO — T¥0'0 • ° — ¥ 2 0"' 

To Reduce Fractions to Decimals. Divide the numerator by the denominator, 
adding ciphers as long as may be necessary. Thus — 

Reduce f to a decimal. £j$g- h- 8 = T y % = .875. 

Reduce f to a decimal. § {${$ ~ 6 = T %\%% -f — .8333 +. 

Reduce ^ to a decimal. dMlfo "*" 400 =" t°o°o¥o = -0025. 

To Add Fractions. Reduce the fractions to a common denominator; add 
their numerators together, and place the sum over a common denominator; 
thus — 

Add together f , f, and |. £ -f A '+ H = ft -= 2 J- 

2b Subtract Fractions. Find the common denominator, as in the preceding 
instance, and place the difference of the numerators above it. Thus — 

Subtract J from ^. ^ — -^ = y 1 ^. 

Subtract TT from }. T 7 7 — \\ = 7 4 y . 

To Multiply Fractions. Multiply the numerators together for a new numer- 
ator, and the denominators for a new denominator. Thus — 

6 100 8 _ 1 
7' 90720 — 9* 

To Multiply Fractions by a Whole Number. Multiply the numerator of the 
fraction by the whole number, and place the result above the denominator. 
Thus— 

Multiply T \ by 9. 3 5 eX9=ff = H. 

To Multiply a Whole Number by a Fraction. Multiply the whole number by the 
numerator of the fraction, and divide by its denominator. Thus — 

Multiply 29 by f . 29 X 3 = 87 -*- 4 = 21f . 

To Divide Fractions. Invert the divisor ; then form new numerators and de- 
nominators, by separately multiplying each of these together. Thus — 

Divide f by f. fXf--=!f-=H. 

Divide 12f by 4J. ¥ X A =» ttf =" *fc 

To Divide Fractions by a Whole Number. Multiply the denominator of the 
given fraction by the whole number, and place the result beneath the numer- 
ator. Thus — 

Divide T V by 4. JJ, "^- 4 = & = fc 

To Divide a Whole Number by a Fraction. Multiply the denominator by the 
whole number, and divide the result by the numerator. Thus — 

Divide 45 by f. 45 X 6 = 270 ■+■ 3 = 90. 

Divide 10} by 3f. 10f = - 3 /; and 3f = ^. Therefore, ^-5- ^ inverted 



APPENDIX. 261 

The above simply shows how many times one fraction or whole number is 
contained in another; for instance, 5 of $ can not be l£, which is simply the 
number of times that $ can be contained in |-. The # of f is ascertained by 
multiplying the numerators for a new numerator, and the denominators for 
a new denominator. Thus — 

What is the I of i? fXf — U. 

Proportions of Chemicals in Dilute Solution. A two per cent, solution of any 
salt, or other substance, means 2 parts of the salt to 100 of water or other 
fluid ; one-half per cent., means 1 part of the chemical to 200 of fluid; one- 
tenth per cent., 1 part to 1,000 of fluid; one per cent., 1 part to 100 of fluid. 
The French prepare solutions as follows: Potassa at the tenth, means 1 part 
of potassa to 10 parts of water ; acetic acid at the fifth, is 1 part of acetic 
acid to 5 parts of water, and so on. 

XXVII. Table. 

Of Symbols or Formulae. 

Those articles to which a star (*) is prefixed, have no trustworthy symbols, 
as several of them are found to vary, while others have not been formulated, 
except empirically. Margarin is, at present, believed to be a mixture of two 
substances. 

Acetate of Lead, neutral (C 2 H 3 2 ) 2 Pb. 3Aq. 

basic (C 2 H 3 2 ) 2 Pb, 2 Pb O. 

Soda (C 2 H 3 2 ) Na. 

" Uranium Ur 2 2 (C 2 H s 2 ) 2 + 2 Aq. 

Acetic Acid, anhydrous C 2 H 4 2 . 

Acetic Acid H (C 2 H 3 2 ). 

Acetone C 3 H 6 O. 

Aconitia C 54 H 40 N 2 . 

♦Albumen; in varying proportions of C 400 H 310 N 50 O 120 S 2 P. 

Alcohol C 2 H 5 (O H). 

* Alkapton. 

Allantoin C 4 N 4 H 6 3 . 

Alloxan C 4 N 2 H 2 4 . 

Alloxantine C 8 ^ 4 H 4 7 3 Aq. 

Ammonia, gas N H 3 . 

liquid NH 4 -HO. 

Ammonio-magnesian Phosphate Mg N H 4 P 4 + 6 Aq. 

* Ammonio-oxide of Copper N 2 H 6 Cu 2 (?). 

Ammonio-sodic Phosphate Na 3 N H 3 P 4 . 

Amygdalin C 20 H 27 NO n 3 HO a . 

Antimony Sb. 

Arsenic As. 



262 APPENDIX. 

Arseniureted Hydrogen As H 3 . 

Atropia C 17 H 23 N0 3 . 

Barium Ba. 

Baryta Ba O. 

" hydrate, crystals Ba H 2 2 8 Aq. 

Benzamide N H 2 C 7 H 5 O. 

Benzoate of Lithia C 7 H 5 2 Li. 

Benzoglycholic Acid C 9 H 8 4 . 

Benzoic Acid C 7 H 5 O, HO. 

Bicarbonate of Soda Na H C 3 . 

Bichloride of Platinum Pt Cl 4 . 

Bichromate of Potassa... K 2 Cr 2 7 . 

Bilirubin C 16 H 18 N 2 3 . 

*Biliverdin C 8 H 9 J* 3 (?). 

Bimeta-antimoniate of Potassa Sb 2 5 K 2 O 7H 2 O. 

Bisulphide of Carbon CS 2 . 

Bromide of Potassium K Br. 

Bromine Br. 

Butyric Acid H C 4 H 7 2 . 

Calcium Ca. 

Carbolic Acid ..C 6 H 6 O. 

Carbonate of Ammonia (N H 4 ) 2 C 3 . 

" Barium Ba C 3 . 

" Lime Ca C 3 . 

" Magnesia, anhydrous Mg C 3 . 

11 " hydrated 4 C 3 Mg, Mg H 2 2 , 6 HO. 

(Composition of above not constant.) 
Silver... Ag 2 C0 3 . 

" Soda Na 2 C 3 . 

Carbonic Acid, gas C 2 . 

* Casein, an albuminoid. 

Chloral C 2 H Cl 3 2 

Chlorate of Potassa K CI 3 . 

Chloride of Ammonium. N H 4 CI. 

" Barium Ba Cl 2 . 

Gold and Soda Au Cl 3 Na CI 2H 2 O. 

" Lime Ca Cl 2 . 

" Sodium Na CI. 

" Tin SnCl 2 (proto) and Sn Cl 4 (bi.) 

Clilorine CI. 

Chloroform -C H Cl 3 . 

* Chlorophyll C 9 H 9 N 4 (?). 

Cholalic Acid C 26 H 40 N S 7 . 

Cholepyrrhine. See Bilirubin. 

Cholesterin C 26 H 44 O. 



APPENDIX. 263 

CholicAcid C 24 H 40 5 . 

Cholinic Acid C 26 H 45 S 2 N 7 . 

Choloidic Acid C 24 H 38 4 . 

Chromate of Potassa, neutral K 2 Cr 4 . 

Cinnamic Acid C 9 H 3 2 . 

Copaivic Acid C 20 H 30 2 . 

Copper Cu. 

Creatine C 4 H 9 N 3 2 2 Aq. 

Creatinine C 4 H 7 N 3 O. 

Creosote , C 8 H 9 (C 6 H 5 ) 2 C 8 H 10 3 . 

Cryptophanic Acid H 2 C 5 H 7 N 5 . 

Curainic Acid C 10 H 1X 2 . 

Cyanate of Ammonia, hydrated N H 4 CNO. 

Cyanide of Mercury Hg (C N) 2 . 

Cystine C 3 H 7 N S 2 . 

Damaluric Acid C 7 H 12 2 . 

Deutoxide of Copper Cu 2 O. 

Ether (C 2 H 5 ) 2 0. 

Ferrocyanide of Potassium K 4 Fe (C N) 6 . 

* Fibrin, variable. 

Fuchsin ....C 20 H 19 N 3 . 

Gallic Acid C 7 H 6 5 . 

Glycerin C 3 H 8 3 . 

Glycocoll C 2 H 5 N 2 . 

Glucogene *) 

Glucose V C 6 H 12 6 . 

Grape Sugar J 

Guanine C 5 H 5 N 5 O. 

*Haematin C 68 H 70 N 8 Fe 2 O 10 . 

* Hsematocrystallin. 

*Ha 5 matoidin C 7 H 9 O, N O (?). 

Hippuric Acid C 9 H 9 N 3 . 

Hydrochlorate of Ammonia N H 4 CI. 

Anilin C 6 H 8 N CI. 

Hydrochloric Acid ... H 01. 

Hypochlorite of Lime Ca Cl 2 2 . 

" Soda NaClO. 

Hypoxanthin C 5 H 4 jN" 4 O. 

Indigo-blue .' C 8 H 5 NO. 

SulphiiSg^lTte of Potassium } ° 8 H * N0 S ° 2 0K ' 

♦Indigo-glucin , C 6 H 10 6 (?). 

Inosite C 6 H 12 6 . 

Iodine I. 

Iron Fe. 



264 APPENDIX. 

Lactic Acid C 3 H 6 3 . 

Lead Pb. 

Leucin C 6 H 13 N 2 . 

Lithium Li. 

Lithia Li 2 O. 

Magnesia.., Mg O. 

Margaric Acid C 17 H 34 3 . 

♦Margarin C 54 H 104 6 6 . 

Mercury Hg. 

Molybdate of Ammonia Mo 4 (N H 4 ) 2 . 

Morphia C 17 H 19 N 3 . 

Murexan C 4 H 5 N 3 3 . 

Murexide C 6 H 6 N 5 4 . 

Nickel Ni. 

Nitrate of Silver Ag N 3 . 

Nitrate of Urea C O H 4 N 2 , H N 3 . 

Nitric Acid H N 3 . 

Nitro-prusside of Sodium Na 2 N O, Fe 2 C N. 

Nitroso-nitric Acid H N 3 + N 2 4 . 

Oleic Acid C 18 H 34 2 . 

Olein (C, H 5 ) (C 18 H 33 2 ) s . 

Oxalate of Ammonia. (N H 4 ) 2 C 2 4 2 Aq. 

" Lime Ca C 2 4 4 Aq. 

Urea (C O H 4 N 2 ) 2 C 2 H 2 4 . 

Oxalic Acid C 2 H 2 4 . 

Parabanic Acid C 3 H 2 N 2 O s . 

Perchlorate of Potassa K CI 4 . 

Perchloride of Iron Fe 2 Cl 6 . 

Permanganate of Potassa K Mn 4 . 

Pernitrateof Mercury 2 (Hg (N 3 ) 3 ) H 2 -f- O. 

Phosphate of Lime, acid H Ca P 4 . 

basic Ca 3 (P 4 ) 2 . 

Phosphate of Magnesia H Mg P 4 7 HO. 

Phosphate of Potassa K 3 P 4 . 

Phosphate of Soda, acid H 2 Na P 4 . 

" " neutral... H Na 2 P 4 . 

" " and Ammonia Na 2 N H 4 P 4 . 

Phosphoric Acid H 3 P 4 . 

Phosphorous Acid H 3 P 3 . 

Phosphorous P. 

Picric Acid C 6 H 3 N 3 7 . 

Picro-carminate of Ammonia. 

Platinum Pt. 

Potassa K HO. 

Protonitrate of Mercury Hg 2 (N 3 ) 2 . 



APPENDIX. 265 

Protoxide of Copper Cu O. 

Prussiate of Potassium, red. K 3 Fe (C N) 6 . 

Purpurate of Ammonia C 8 N 6 H 8 6 Aq. 

Purpuric Acid C 8 N 5 H 5 6 . 

Purpurin C 9 H 6 3 H 2 O. 

Pyrophosphate of Magnesia Mg 2 P 2 7 . 

Quinia C 10 H 24 N 2 2 . 

Salicin C 13 H 18 7 . 

Salicylic Acid C 7 H 6 3 . 

Santonin C 15 H 18 3 . 

Silicate of Potassa K 2 Si 3 . 

Silver Ag. 

Stearic Acid C 18 H 36 2 . 

Stearin , (C 3 H 5 ) (C 18 H 35 2 ) 8 . 

Strychnia C 21 H 22 N 2 2 . 

Succinic Acid C 4 H 6 4 . 

Sugar, cane -= C 12 H 22 O n . 

" grape... , C 6 H 12 6 + H 2 0. 

Sulphate of Copper, crystals Cu S0 4 -f 5 Aq. 

■ Potassa.. K 2 S 4 . 

Sulphide of Ammonia N H 4 H 2 S. 

" Calcium Ca S. 

" Carbon C S 2 . 

Sulphomolybdate of Ammonia (1ST H 4 ) 2 S Mo S s . 

Sulphur S. 

Sulphureted Hydrogen H 2 S. 

Sulphuric Acid H 2 S 4 . 

Sulphurous Acid, gas S 2 . 

" " liquid H 2 S0 3 . 

Tannin C 27 H 22 17 . 

Taurin C 4 H 7 N S 2 3 . 

Taurylic Acid C 7 H 8 O. 

Thionurate of Ammonia N H 4 (N 3 H 4 C 4 S 8 ) 3 . 

Thionuric Acid C 4 H 5 N 3 S 6 . 

Trimethylamin C 3 H 9 N. 

Tyrosin C 9 H 1X N 3 . 

Uranium Ur. 

Urate of Ammonia, acid. C 5 H 3 (N H 4 ) N 4 8 . 

" Lime, acid C 5 H 2 N 4 Ca 3 . 

" Magnesia, acid C 5 H 2 N 4 Mg 3 . 

" Potassa, acid C 5 N 4 II 3 K 3 . 

" Soda, acid C 5 H 3 N 4 Na 3 . 

" il neutral C 5 H 2 N 4 Na a O a . 

Urea C H 4 N 2 0. 



266 APPENDIX. 

Uric Acid C 5 H 4 N 4 3 . 

*TJrochloralic Acid. 

* Uroglaucin. 

* Urohematin. 
*TJrophein. 

* Urosacme. 

* Urostealith. 

* Uroxanthin. 

* Urrhodin. 

Veratria C 56 H 86 N 2 15 . 

Xanthine 

Thermometric Conversions. 

1. To Convert any Degree of Centigrade above 0° to One of Fahrenheit. (0° C. 
= + 32° F.) 

Multiply the centigrade degree by 9, then divide by 5, and to the result add 
32. Thus : 11° C. X 9 ^ 5 = 19.8 + 32 = + 51° 8 F. 

2. To Convert any Degree of Centigrade below 0° to One of Fahrenheit. ( — 17° 
7778 C. = 0° F.) 

Multiply the centigrade degree by 9, then divide by 5, and subtract the 
result from 32. Thus : — 11° C. X 9 -*■ 5 -*■ 19.8 — 32 — + 12° 2 F. 

N. B. But if 32 has to be subtracted from the result, then the Fah. degree 
obtained is — minus, or below 0°. Thus : —21° C.X9-f-5 = 37.5 — 32 == 
— 5° 8 / Fah. 

3. To Convert any Degree of Fahrenheit above -J- 32° to One of Centigrade, (-f- 
32°F. = o C.) 

Subtract 32 from the Fah. degree, then multiply by 5, and divide the re- 
sult by 9. Thus : 34° F. — 32 = 2 X 5 h- 9 = + 1° 1111 C 

4. To Convert any Degree of Fahrenheit below -f- 32° to One of Centigrade. 
(— 0° F. = — 17° 7778° C. All degrees of Fah. below 4- 32 form — minus 
degrees of Cent.) 

Subtract the Fah. degree from 32, then multiply by 5, and divide by 9. 
Thus: 30°F. — 32 = 2X5-^9 = — 1° 1111 C. 

N. B. But if the Fah. degree is minus or below 0°, then add 32 to it, 
multiply by 5 and divide by 9. Thus : —6° F. + 32 = 38 X 5 -*- 9 = — 21° 
1111 C. 

( — 40° F. + 32 = 72 X5-^-9=- — 40° C.) 



THE END. 



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